Usage
- This combination medication is primarily prescribed for the management and treatment of conditions related to calcium and vitamin D deficiency, such as osteoporosis, osteomalacia (rickets in children), and hypoparathyroidism. It’s also used as an adjunct in managing secondary hyperparathyroidism in patients undergoing renal dialysis. Some formulations also include additional ingredients (like zinc, magnesium, methylcobalamin or folic acid) that act synergistically to promote bone health, nerve function and cell metabolism.
- Pharmacological Classification: Vitamin and Mineral Supplement.
- Mechanism of Action: This combination works by increasing calcium absorption, promoting bone formation, and improving bone density. Calcitriol (the active form of vitamin D3) enhances the intestinal absorption of calcium and phosphate. Calcium carbonate provides a source of elemental calcium necessary for bone mineralization. Vitamin K2-7 (menaquinone-7) helps to direct calcium into the bones and prevent its deposition in soft tissues like blood vessels.
Alternate Names
- There is no officially recognized alternate name for this specific combination. However, it may be referred to by various descriptions reflecting its components, such as “calcium, vitamin D3, and vitamin K2-7 supplement.”
- Brand Names: Several brand names exist for this combination, with formulations often including additional ingredients. Brand names often include variations of “Cal” “Vit D” “K2” and sometimes also “Zinc”, “Mg” and “B12” depending on specific content.
How It Works
- Pharmacodynamics: Calcitriol acts on the vitamin D receptor (VDR) in the intestine, kidneys, and bone to regulate calcium and phosphate homeostasis. It increases intestinal calcium absorption, promotes renal calcium reabsorption, and mobilizes calcium from bone. Calcium carbonate provides a readily absorbable source of calcium. Vitamin K2-7 activates osteocalcin, a protein that binds calcium to the bone matrix, and matrix Gla protein (MGP), which inhibits calcium deposition in blood vessels.
- Pharmacokinetics: Calcitriol is absorbed from the small intestine and undergoes hepatic metabolism. Calcium carbonate is absorbed via an active, vitamin D-dependent transport mechanism. Vitamin K2-7 is absorbed in the presence of bile salts. All components are metabolized in the liver and eliminated through renal and biliary excretion.
Dosage
The dosage is dependent on the specific product formulation, the patient’s age, the severity of the deficiency, and the presence of any underlying medical conditions. Please consult the packaging insert for detailed information regarding dosage recommendations.
Side Effects
Common Side Effects
- Constipation
- Stomach upset
- Nausea
- Vomiting
- Loss of appetite
- Weakness
- Tiredness
- Headache
Rare but Serious Side Effects
- Hypercalcemia (high blood calcium levels) manifested by symptoms like nausea, vomiting, constipation, increased thirst, and confusion.
- Allergic reactions characterized by skin rash, itching, hives, swelling of the face, lips, tongue, or throat, difficulty breathing.
Contraindications
- Hypercalcemia
- Hypervitaminosis D
- Hypersensitivity to any component of the formulation
- Severe renal impairment
- Kidney stones
Drug Interactions
- Thiazide diuretics
- Digoxin
- Corticosteroids
- Bile acid sequestrants
- Anticonvulsants
- Antibiotics (tetracyclines, quinolones)
- Antacids containing magnesium
- Iron supplements
Pregnancy and Breastfeeding
This combination should be used with caution during pregnancy and breastfeeding, and only if the potential benefits outweigh the risks. Consult a physician before use.
Drug Profile Summary
- Mechanism of Action: Enhances calcium absorption, supports bone formation, and improves bone density.
- Side Effects: Gastrointestinal issues, weakness, headache, hypercalcemia (rarely).
- Contraindications: Hypercalcemia, hypervitaminosis D, hypersensitivity, severe renal impairment.
- Drug Interactions: Thiazide diuretics, digoxin, corticosteroids, certain antibiotics, antacids, iron supplements.
- Pregnancy & Breastfeeding: Use with caution; consult a physician.
- Dosage: Varies depending on the formulation and patient factors.
- Monitoring Parameters: Serum calcium, phosphorus, creatinine, and vitamin D levels.
Popular Combinations
This combination is often formulated with additional ingredients like magnesium, zinc, or methylcobalamin to enhance its effects.
Precautions
- Monitor serum calcium levels regularly.
- Ensure adequate hydration.
- Exercise caution in patients with a history of kidney stones.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcitriol + Calcium Carbonate + Vitamin K2-7?
A: The recommended dosage is dependent on the individual patient’s condition and the specific formulation used. Consult the specific product information for detailed instructions.
Q2: What are the common side effects?
A: Common side effects include constipation, stomach upset, nausea, and headache.
Q3: Who should not take this combination?
A: Individuals with hypercalcemia, hypervitaminosis D, or severe renal impairment should not take this medication.
Q4: Can pregnant or breastfeeding women take this medication?
A: Pregnant or breastfeeding women should consult a physician before using this medication.
Q5: What are the signs of hypercalcemia?
A: Signs of hypercalcemia include nausea, vomiting, constipation, increased thirst, confusion, and fatigue.
Q6: What are the drug interactions I should be aware of?
A: This medication may interact with several medications, including thiazide diuretics, digoxin, corticosteroids, and certain antibiotics.
Q7: How should this medication be stored?
A: Store this medication at room temperature, away from moisture and heat.
Q8: What should I do if I miss a dose?
A: If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up.
Q9: Can this combination be used in children?
A: The use of this combination in children should be under the guidance of a physician.
Q10: What lifestyle changes can support bone health?
A: Maintaining a balanced diet rich in calcium and vitamin D, engaging in regular weight-bearing exercise, and limiting alcohol and caffeine intake can support bone health.
