Becoral-D
Generic Name
Calcium Carbonate (equivalent to Elemental Calcium 500 mg) + Vitamin D3 400 IU Tablet
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| becoral d 500 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Becoral-D 500 mg Tablet is a combination medicine containing Calcium Carbonate and Vitamin D3. It is primarily used to treat and prevent calcium and vitamin D deficiencies, and to support bone health in various conditions like osteoporosis, osteomalacia, and rickets. It is also prescribed during pregnancy, lactation, and in individuals with increased calcium requirements.
Uses & Indications
Dosage
Adults
Typically, 1-2 tablets daily, or as directed by the physician. Tablets should be swallowed whole with water.
Elderly
Same as adult dosage, but caution should be exercised in patients with renal impairment or those prone to hypercalcemia.
Renal_impairment
Use with caution. Dosage adjustment may be required based on creatinine clearance and serum calcium levels. Regular monitoring of serum calcium is recommended.
How to Take
The tablet should be swallowed whole with a glass of water, with or without food. For best absorption, it may be taken after meals.
Mechanism of Action
Calcium is an essential mineral required for maintaining bone density, nerve transmission, muscle contraction, and various metabolic functions. Vitamin D3 (Cholecalciferol) facilitates the absorption of calcium from the gastrointestinal tract and helps regulate calcium and phosphate levels in the body, promoting proper bone mineralization.
Pharmacokinetics
Onset
Therapeutic effects are gradual, building over weeks to months with consistent use.
Excretion
Calcium is primarily excreted via feces, with a smaller portion via urine. Vitamin D metabolites are excreted mainly in bile and feces, with some renal excretion.
Half life
The half-life of Vitamin D3 is approximately 15-30 days, while calcium is continually recycled in the body.
Absorption
Calcium absorption from the gut is variable and depends on various factors including Vitamin D status. Vitamin D3 is well absorbed from the small intestine, especially in the presence of bile salts.
Metabolism
Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D (calcifediol) and then in the kidneys to the active form, 1,25-dihydroxyvitamin D (calcitriol). Calcium is not extensively metabolized.
Side Effects
Contraindications
- Hypersensitivity to the active substances or to any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Nephrolithiasis (kidney stones)
- Primary hyperparathyroidism
- Sarcoidosis
Drug Interactions
Digoxin
Hypercalcemia can increase the risk of digoxin toxicity. Monitor ECG and serum calcium levels.
Levothyroxine
Calcium can impair levothyroxine absorption. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce the absorption of bisphosphonates. Administer calcium at a different time of day.
Corticosteroids
Can reduce calcium absorption and impair vitamin D action, potentially necessitating higher doses of calcium and vitamin D.
Thiazide diuretics
May reduce calcium excretion and lead to hypercalcemia. Monitor serum calcium levels.
Tetracyclines and Fluoroquinolones
Calcium can decrease the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after calcium supplements.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria (frequent urination), polydipsia (excessive thirst), and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing the supplement, hydrating the patient, and monitoring serum calcium levels and kidney function. In severe cases, specific medical interventions may be necessary.
Pregnancy & Lactation
Becoral-D is generally considered safe and often recommended during pregnancy and lactation to meet increased calcium and vitamin D requirements. However, the dose should be determined by a healthcare professional to avoid excessive intake, which could be harmful.
Side Effects
Contraindications
- Hypersensitivity to the active substances or to any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Nephrolithiasis (kidney stones)
- Primary hyperparathyroidism
- Sarcoidosis
Drug Interactions
Digoxin
Hypercalcemia can increase the risk of digoxin toxicity. Monitor ECG and serum calcium levels.
Levothyroxine
Calcium can impair levothyroxine absorption. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce the absorption of bisphosphonates. Administer calcium at a different time of day.
Corticosteroids
Can reduce calcium absorption and impair vitamin D action, potentially necessitating higher doses of calcium and vitamin D.
Thiazide diuretics
May reduce calcium excretion and lead to hypercalcemia. Monitor serum calcium levels.
Tetracyclines and Fluoroquinolones
Calcium can decrease the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after calcium supplements.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria (frequent urination), polydipsia (excessive thirst), and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing the supplement, hydrating the patient, and monitoring serum calcium levels and kidney function. In severe cases, specific medical interventions may be necessary.
Pregnancy & Lactation
Becoral-D is generally considered safe and often recommended during pregnancy and lactation to meet increased calcium and vitamin D requirements. However, the dose should be determined by a healthcare professional to avoid excessive intake, which could be harmful.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Pharmacies, drugstores
Approval Status
Approved by regulatory authorities in Bangladesh (DGDA)
Patent Status
Off-patent
Clinical Trials
Numerous clinical trials support the efficacy of calcium and vitamin D supplementation for bone health, osteoporosis prevention, and treatment of deficiencies. Specific brand-level trials might be available but typically generic combinations rely on established clinical evidence.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or those on prolonged therapy)
- Serum phosphate levels
- 25-hydroxyvitamin D levels
- Renal function tests (e.g., serum creatinine, eGFR) in patients with kidney issues or on long-term treatment
- Urinary calcium excretion (if hypercalciuria is suspected)
Doctor Notes
- Educate patients on dietary sources of calcium and vitamin D.
- Advise patients about the importance of adherence to dosage to avoid both deficiency and toxicity.
- Consider baseline and periodic monitoring of serum calcium and vitamin D levels, especially in patients with pre-existing conditions or on concomitant medications.
- Counsel on potential drug interactions, particularly with antibiotics and thyroid hormones.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor or as indicated on the package.
- Do not exceed the recommended dose without consulting your healthcare provider.
- Maintain adequate fluid intake while taking this supplement.
- Inform your doctor about all other medications and supplements you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Becoral-D is not known to affect the ability to drive or operate machinery. No special precautions are necessary.
Lifestyle Advice
- Ensure a balanced diet rich in calcium-containing foods (e.g., dairy products, leafy greens).
- Engage in regular weight-bearing exercise to support bone health.
- Get adequate sun exposure for natural vitamin D production, while protecting against harmful UV rays.
- Avoid smoking and excessive alcohol consumption, as these can negatively impact bone density.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.