Usage
This combination medication is primarily prescribed for the prevention and treatment of conditions related to deficiencies in the listed vitamins and minerals, particularly in bone health and certain metabolic processes. It is often used in individuals at risk for or diagnosed with osteoporosis, osteopenia, and vitamin deficiencies (especially during pregnancy). It may also be prescribed to support overall bone health, particularly in postmenopausal women or individuals with increased fracture risk. Additionally, it may be used to address deficiencies arising from malabsorption syndromes or dietary restrictions.
Pharmacological Classification: This combination product falls under multiple classifications, including vitamin supplement, mineral supplement, bone health agent, and hematopoietic agent (due to the inclusion of B vitamins and folate which are essential for red blood cell formation).
Mechanism of Action: This combination medication works by providing the necessary nutrients for maintaining and improving bone health, supporting nerve function, and contributing to red blood cell formation.
Alternate Names
There is no one single official alternate name for this combination. It is typically referred to by the names of its components. The specific components or ratios may vary in different formulations. Brand names vary depending on the manufacturer. Some examples include Caltuf and Calshang K27.
How It Works
Pharmacodynamics:
- Calcium Citrate Malate: Provides calcium, essential for bone mineralization, muscle contraction, nerve transmission, and blood clotting. Citrate malate improves calcium absorption.
- L-Methyl Folate Calcium: The biologically active form of folate, vital for DNA synthesis, cell division, and red blood cell formation. It also plays a role in bone health.
- Methylcobalamin: A form of vitamin B12, crucial for nerve function, DNA synthesis, and red blood cell formation.
- Pyridoxal-5-Phosphate: The active form of vitamin B6, important for various metabolic processes, including protein metabolism and nerve function. It’s also involved in collagen synthesis, which supports bone health.
- Vitamin D3 (Cholecalciferol): Enhances calcium absorption in the gut and maintains calcium and phosphate homeostasis, critical for bone mineralization.
- Vitamin K2-7 (Menaquinone-7): Plays a crucial role in bone metabolism by activating osteocalcin, a protein that binds calcium to bone matrix, thereby promoting bone mineralization and preventing calcium deposition in soft tissues.
Pharmacokinetics:
- Absorption: Absorption of calcium citrate malate is enhanced by the citrate component. L-methyl folate is readily absorbed. Vitamin B12 absorption requires intrinsic factor in the stomach. Pyridoxal-5-phosphate, Vitamin D3, and Vitamin K2 are absorbed with fats in the diet.
- Metabolism: Vitamins B6 and K are metabolized in the liver. Vitamin D3 is hydroxylated in the liver and kidneys to its active form, calcitriol.
- Elimination: Calcium is primarily excreted in urine and feces. Excess B vitamins are excreted in urine. Vitamin K is primarily excreted in bile and feces. Vitamin D metabolites are excreted in bile and urine.
Dosage
Dosage guidelines for this specific combination product are not standardized and should be determined by a healthcare professional based on individual patient needs and the specific product formulation. The information below represents general dosing ranges for the individual components and should not be interpreted as a recommendation for this combination product.
Standard Dosage
Adults:
Dosage varies by product and individual needs. See brand name package instructions.
Children:
Consult a pediatrician. Dosage should be based on the child’s age, weight, and specific needs.
Special Cases:
Dosage adjustments should be determined on a case-by-case basis by a physician, taking into account the patient’s specific conditions and potential drug interactions.
Clinical Use Cases
This combination is not typically used in acute medical settings like intubation, surgical procedures, mechanical ventilation, or emergency situations. Its usage is primarily focused on long-term nutritional supplementation for bone health and prevention of vitamin/mineral deficiencies.
Dosage Adjustments
Dosage adjustments may be necessary for patients with renal or hepatic impairment, as well as those with other medical conditions. A physician should carefully evaluate the patient’s specific situation and adjust the dosage accordingly.
Side Effects
Common Side Effects
Constipation, nausea, and gastrointestinal upset are possible.
Rare but Serious Side Effects
Hypercalcemia (with excessive calcium intake).
Long-Term Effects
Potential for kidney stones with excessive calcium intake over prolonged periods.
Adverse Drug Reactions (ADR)
Allergic reactions are possible but rare.
Contraindications
Hypersensitivity to any of the ingredients. Hypercalcemia, hypervitaminosis D, and severe renal impairment are relative contraindications.
Drug Interactions
Certain antibiotics, bisphosphonates, and other medications can affect calcium absorption. Antacids can reduce the absorption of iron and certain B vitamins. Consult a doctor about specific interactions.
Pregnancy and Breastfeeding
This combination can generally be used safely during pregnancy and breastfeeding, but it is essential to consult a healthcare professional for appropriate dosage guidance.
Drug Profile Summary
Mechanism of Action: See “How It Works” Section.
Side Effects: See “Side Effects” Section.
Contraindications: See “Contraindications” Section.
Drug Interactions: See “Drug Interactions” Section.
Pregnancy & Breastfeeding: Generally safe, but consultation with a doctor is crucial.
Dosage: Varies by product and individual needs.
Monitoring Parameters: Calcium levels (especially in long-term use).
Popular Combinations
This combination is often prescribed on its own.
Precautions
Standard precautions apply, including screening for potential allergies and assessing patient history of kidney stones or other related conditions.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Citrate Malate + L-Methyl Folate Calcium + Methylcobalamin + Pyridoxal-5-phosphate + Vitamin D3 + Vitamin K2-7?
A: The recommended dosage is determined by individual patient needs and the specific product formulation. Always follow the healthcare provider’s instructions or the package insert for dosage guidelines.
Q2: What are the key benefits of this specific combination?
A: This combination addresses multiple nutritional needs related to bone health, nerve function, and red blood cell formation, providing a comprehensive approach to supporting these systems.
Q3: Can this combination be used during pregnancy and breastfeeding?
A: Generally yes, but consult with a healthcare provider for appropriate dosing.
Q4: Are there any specific drug interactions to be aware of?
A: Yes, consult a doctor regarding any potential drug interactions, especially with antibiotics, bisphosphonates, and antacids.
Q5: What are the potential side effects?
A: Common side effects may include constipation, nausea, and gastrointestinal upset. Rarely, hypercalcemia may occur with excessive calcium intake.
Q6: What are the contraindications for using this combination?
A: Contraindications include hypersensitivity to any of the ingredients, hypercalcemia, and severe renal impairment.
Q7: How is this combination different from taking individual supplements?
A: It offers the convenience of a combined formulation, ensuring intake of all components in specified ratios.
Q8: Are there any specific monitoring parameters for patients taking this combination?
A: Monitoring calcium levels is advisable, especially with long-term use.
Q9: How should this medication be stored?
A: Store as directed on the product label, typically in a cool, dry place away from direct sunlight and out of reach of children.
