Introduction
Calcivit® D is a vitamin-mineral combination preparation consisting of calcium carbonate 1500 mg (equivalent to 600 mg calcium) and vitamin D3 (cholecalciferol) 400 I. U. to be taken twice daily. If the preparation is used during pregnancy, however, it may only be taken once a day at most. It is available in pharmacies but not on prescription and is supplied in the form of effervescent or chewable tablets. The effervescent tablets are additionally available as Calcivit® D forte. Calcivit® D forte contains 2500 mg calcium carbonate (equivalent to 1000 mg calcium) and 880 I. E. Vitamin D3 (cholecalciferol).
Fields of application
Calcivit® D is used to compensate combined calcium and vitamin D3 deficiencies or to prevent such deficiencies. This plays a role especially in osteoporosis prophylaxis and osteoporosis treatment. Special features during intake: While taking Calcivit® D, kidney function should be checked at regular intervals by determining the creatinine value in serum.
In addition, the calcium level in serum and urine should be determined repeatedly. This is particularly important in patients who are taking cardiac glycosides (digitoxin) and/or diuretics at the same time and who are of advanced age. Enormous attentiveness is also required with concomitant therapy with bisphosphonates, sodium fluoride or tetracyclines.
If a further preparation containing vitamin D3 is taken, the total dose of vitamin D3 supplied must be taken into account. In patients suffering from sarcoidosis (Boeck’s disease), there is an increased change of vitamin D3 to its active metabolites. Here too, the calcium level in blood and urine should be checked at regular intervals. Please inform your treating physician if you suffer from renal insufficiency, as the vitamin D3 metabolism is disturbed here.
Side effects
In rare cases, treatment with Calcivit® D can lead to gastrointestinal complaints, such as Overdosage may also cause similar symptoms such as vomiting and excessive thirst. In rare cases: can also be observed. Long-term treatment and concomitant renal insufficiency may result in hypercalcemia, i.e. an increase in calcium concentration and/or hypercalciuria, i.e. increased excretion of calcium in the urine. – Diarrhoea
- Constipation
- Flatulence
- Stomach pain and
- Nausea
- Skin rashes
- Itching and
- Hives (Urticaria)
Interactions
Interactions with diuretic agents (thiazide-type diuretics, such as hydrochlorothiazide) may occur, which may eventually cause hypercalcemia. The effect of vitamin D3 can be disturbed by the following drugs: When taking colestyramine for hypercholesterolemia (high blood cholesterol levels), there should be an interval of at least two hours between the intake of Calcivit® D and colestyramine, otherwise the absorption of Calcivit® D in the gastrointestinal tract may be impaired. The absorption of iron may also be disturbed by Calcivit® D. Therefore, iron-containing preparations should be taken two hours before or two hours after taking Calcivit® D. This interval of two hours also applies to the cytostatic drug Estramustin.
For certain antibiotics, such as tetracyclines or bisphosphonates and sodium fluoride, the interval should be at least three hours. Since taking Calcivit® D can lead to an increase in the blood calcium level, it is possible that sensitivity to drugs used in heart failure (cardiac glycosides) is increased and the risk of cardiac arrhythmia is increased. Interactions with food are also known.
Foodstuffs may be involved:
- Barbiturates
- Glucocorticoids
- Phenytoin and
- Rifampicin
- Oxalic acid (such as rhubarb, star fruits, chard, cocoa and many more)
- Phytic acid (for example in corn, soya or peanuts)
- Phosphates (for example in processed cheese or soft drinks) or
- Foodstuffs with a significant fibre content
Calcivit® D can be used during pregnancy and lactation to compensate for calcium and vitamin D3 (cholecalciferol) deficiency. However, it is important that a maximum of 1 tablet per day is taken so that a daily dose of 1500 mg calcium and 600 I. U. is not exceeded. When breast-feeding, it is important to note that calcium and vitamin D3 (cholecalciferol) pass into breast milk.
Calcivit® D should be taken by pregnant and breastfeeding women two hours before or after a meal, otherwise the absorption of iron in the gastrointestinal tract may be impaired. Calcivit® D must not be part of the therapy plan if patients are prone to hypersensitivity reactions to it. In addition, it must not be taken if there is an elevated blood calcium concentration (hypercalcemia), increased calcium excretion via urine (hypercalcuria) or long-term immobilization with hypercalcemia and/or hypercalcuria.
Further contraindications for a therapy with Calcivit® D are Caution is required for the following conditions: In case of any uncertainties, it is essential to consult your doctor or pharmacist. – Calcium carbonate
- Vitamin D3 (cholecalciferol) or
- Other components of this vitamin and mineral preparation (e.g. soya)
- Kidney stones
- Myeloma (cancer of the bone marrow)
- Bone metastases and
- Primary hyperparathyroidism (pHPT), i.e. an overactive parathyroid gland
- Reduced renal function
- Renal calcification
- Lower phosphate concentration in the blood (hypophosphatemia)
