Usage
This combination is primarily used as a nutritional supplement to support bone health, prevent osteoporosis, and reduce the risk of fractures. It may also be prescribed to address deficiencies in any of the included nutrients. It’s classified as a multivitamin/multimineral supplement and bone health agent. The components work synergistically to optimize bone health: calcium and magnesium are structural components of bone, vitamin D enhances calcium absorption, vitamin K2-7 directs calcium to bones, and zinc contributes to bone formation and maintenance.
Alternate Names
While there isn’t a universally recognized alternate name for this specific combination, individual components have their own chemical names or alternative forms. Vitamin D3 may be listed as cholecalciferol, and Vitamin K2-7 as menaquinone-7. Brand names vary depending on the manufacturer; some examples include Ifycal-K27 and Calcivale-K27.
How It Works
Pharmacodynamics: Calcium and magnesium are crucial for bone mineralization and structure. Vitamin D3 promotes calcium absorption in the gut and maintains calcium balance. Vitamin K2-7 activates osteocalcin, a protein that binds calcium to bone matrix. Zinc is essential for bone formation and mineralization.
Pharmacokinetics: Calcium citrate malate is absorbed in the small intestine, influenced by factors like vitamin D levels. Magnesium oxide is absorbed in the gut, but its absorption can be limited. Vitamin D3 is absorbed in the small intestine and undergoes hepatic and renal metabolism. Vitamin K2-7 is absorbed and transported via the lymphatic system. Zinc is absorbed in the small intestine. Elimination routes include renal excretion (calcium, magnesium, zinc, vitamin D metabolites) and biliary excretion (vitamin K).
Dosage
Dosage varies widely depending on the specific formulation and patient needs. It is crucial to follow the prescribed dosage.
Standard Dosage
Adults:
A common dosage recommendation is one or two tablets or capsules per day, taken with a meal. The specific amount of each component will vary based on the formulation. Always refer to the product label and doctor’s instructions.
Children:
Dosage in children should be determined by a pediatrician and is typically based on age and weight. Safety and efficacy in children have not been extensively established for all components.
Special Cases:
- Elderly Patients: Dosage adjustments may be required based on renal function and other health considerations.
- Patients with Renal Impairment: Caution is advised, and dose reduction may be necessary. Close monitoring of calcium, magnesium, and vitamin D levels is important.
- Patients with Hepatic Dysfunction: Adjustments are usually not necessary for mild to moderate hepatic dysfunction, but severe dysfunction may require careful monitoring.
- Patients with Comorbid Conditions: Caution is advised in patients with conditions such as hyperparathyroidism, sarcoidosis, or kidney stones. Dose adjustments may be needed based on the coexisting condition.
Clinical Use Cases
This combination is not typically used for acute medical situations like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations. Its role is primarily in long-term nutritional support for bone health.
Dosage Adjustments
Dosage should be adjusted based on individual patient needs and monitored by a healthcare professional. Serum calcium, magnesium, and 25-hydroxyvitamin D levels may be checked periodically.
Side Effects
Common Side Effects:
Gastrointestinal issues like constipation, diarrhea, nausea, gas, bloating, and stomach upset.
Rare but Serious Side Effects:
Hypercalcemia (high blood calcium), hypervitaminosis D (vitamin D toxicity), allergic reactions, kidney stones (with prolonged use).
Long-Term Effects:
Kidney stones are a potential risk with chronic high-dose calcium supplementation.
Adverse Drug Reactions (ADR):
Severe allergic reactions (rare but require immediate attention).
Contraindications
- Hypercalcemia
- Hypervitaminosis D
- Hypersensitivity to any of the components
- Severe renal impairment
- Malabsorption syndrome
- Certain types of kidney stones
Drug Interactions
- Antibiotics (Tetracyclines, Quinolones): Reduced antibiotic absorption
- Bisphosphonates: Reduced bisphosphonate absorption
- Diuretics (Thiazide diuretics): May increase calcium levels
- Anticoagulants (Warfarin): Vitamin K can interfere with warfarin’s action.
- Levothyroxine: Reduced levothyroxine absorption
- Iron supplements: Reduced iron and zinc absorption
- Antacids: May affect absorption of calcium, magnesium and zinc
- Other medications containing calcium or vitamin D: Risk of hypercalcemia and hypervitaminosis D
Pregnancy and Breastfeeding
Consult a doctor before use during pregnancy or breastfeeding. While generally considered safe in recommended doses, excessive vitamin D intake during pregnancy could be harmful.
Drug Profile Summary
- Mechanism of Action: Provides essential nutrients for bone health, improves calcium absorption, and promotes bone formation.
- Side Effects: Gastrointestinal discomfort, hypercalcemia, hypervitaminosis D (rare).
- Contraindications: Hypercalcemia, hypervitaminosis D, severe renal impairment, hypersensitivity.
- Drug Interactions: Antibiotics, bisphosphonates, diuretics, anticoagulants.
- Pregnancy & Breastfeeding: Consult a doctor before use.
- Dosage: Varies; typically 1-2 tablets/capsules daily with meals.
- Monitoring Parameters: Serum calcium, magnesium, 25-hydroxyvitamin D.
Popular Combinations
This combination itself represents a common grouping of nutrients for bone health. Sometimes, methylcobalamin (vitamin B12) may be added.
Precautions
- Assess for existing medical conditions and medication use.
- Monitor renal function, especially in patients with kidney disease.
- Regularly check calcium and vitamin D levels to avoid toxicity.
- Consult a doctor before using during pregnancy or breastfeeding.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Citrate Malate + Magnesium Oxide + Vitamin D3 + Vitamin K2-7 + Zinc Oxide?
A: Dosage varies based on the specific product and individual needs. It is essential to follow the instructions on the product label and consult with a physician for personalized recommendations. A common adult dose is one or two tablets/capsules per day taken with food.
Q2: Can this combination be used during pregnancy and breastfeeding?
A: Consult a doctor before use during pregnancy or breastfeeding. Dosages should not exceed recommended dietary allowances without medical supervision.
Q3: What are the potential side effects?
A: Common side effects include gastrointestinal discomfort such as constipation, diarrhea, nausea, and bloating. Rarely, hypercalcemia or hypervitaminosis D can occur.
Q4: Who should not take this combination?
A: Individuals with hypercalcemia, hypervitaminosis D, severe renal impairment, or hypersensitivity to any component should avoid this combination.
Q5: Are there any drug interactions I should be aware of?
A: Yes, this combination can interact with certain antibiotics, bisphosphonates, diuretics, anticoagulants, thyroid medication and iron supplements. Inform your doctor about all medications you are taking, including over-the-counter drugs and supplements.
Q6: How long should I take this supplement?
A: The duration of supplementation should be determined by your doctor based on your individual health needs.
Q7: Can this combination be used to treat osteoporosis?
A: This supplement primarily focuses on preventing osteoporosis and reducing fracture risk by supporting bone health. It is not typically a sole treatment for diagnosed osteoporosis but can be used as part of a comprehensive treatment plan prescribed by a physician.
Q8: Can children take this supplement?
A: Dosage for children should be determined by a pediatrician based on their individual needs. Safety and efficacy have not been fully established for all components in children.
Q9: What should I do if I miss a dose?
A: If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
