Calbo-D
Generic Name
Calcium Carbonate 1250 mg (equivalent to Elemental Calcium 500 mg) + Vitamin D3 (Cholecalciferol) 200 IU
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| calbo d 500 mg tablet | ৳ 8.00 | N/A |
Description
Overview of the medicine
Calbo-D 500 mg tablet is a combination of Calcium Carbonate and Vitamin D3 (Cholecalciferol). It is used to prevent and treat calcium and vitamin D deficiencies, particularly in conditions like osteoporosis, osteomalacia, and during periods of increased demand such as pregnancy and lactation.
Uses & Indications
Dosage
Adults
1-2 tablets daily, or as directed by the physician. It is generally recommended to take with meals.
Elderly
Same as adults, but monitoring of calcium levels may be advisable, especially in patients with impaired renal function.
Renal_impairment
Use with caution. Dosage may need to be adjusted based on serum calcium and phosphate levels. Contraindicated in severe renal impairment and hypercalcaemia.
How to Take
For oral administration. Tablets can be chewed or swallowed whole with a glass of water, preferably after meals.
Mechanism of Action
Calcium is an essential mineral vital for strong bones, muscle function, nerve transmission, and hormone secretion. Vitamin D3 helps regulate calcium and phosphate homeostasis, facilitating their absorption from the intestine and promoting bone mineralization. The combination ensures adequate calcium levels and its proper utilization by the body.
Pharmacokinetics
Onset
Therapeutic effects on bone health are gradual and observed with long-term supplementation. Plasma calcium levels may rise within hours of administration.
Excretion
Unabsorbed calcium is excreted in feces. Absorbed calcium is excreted via urine (filtered by glomeruli, reabsorbed by tubules). Vitamin D3 and its metabolites are primarily excreted in bile and feces, with a small amount in urine.
Half life
The half-life of absorbed elemental calcium is complex due to its incorporation into bone. Vitamin D3 (cholecalciferol) has a half-life of about 24 hours, but its active metabolite, calcitriol, has a shorter half-life. Stored vitamin D in adipose tissue has a very long duration.
Absorption
Calcium Carbonate is absorbed from the gastrointestinal tract (approximately 20-30% of elemental calcium). Vitamin D3 is fat-soluble and absorbed efficiently from the small intestine, primarily in the presence of bile salts.
Metabolism
Elemental calcium is largely unbound in the blood, with some portion protein-bound. Vitamin D3 is hydroxylated in the liver to 25-hydroxycholecalciferol (calcidiol), then in the kidneys to 1,25-dihydroxycholecalciferol (calcitriol), the active form.
Side Effects
Contraindications
- Hypercalcaemia (abnormally high levels of calcium in the blood).
- Hypercalciuria (excessive excretion of calcium in the urine).
- Nephrolithiasis (kidney stones) or history of kidney stones.
- Severe renal impairment.
- Hypersensitivity to the active substances or to any of the excipients.
Drug Interactions
Levothyroxine
Calcium can reduce the absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can impair the absorption of bisphosphonates. Take bisphosphonates at least 30 minutes before calcium.
Cardiac glycosides
Hypercalcaemia may potentiate the toxic effects of cardiac glycosides (e.g., digoxin), increasing the risk of arrhythmias.
Thiazide diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcaemia.
Phenytoin and Barbiturates
May reduce the effect of Vitamin D.
Tetracycline and Fluoroquinolone antibiotics
Oral calcium can reduce 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 include nausea, vomiting, constipation, severe thirst, polyuria, and fatigue. In severe cases, hypercalcaemia can lead to renal impairment and cardiac arrhythmias. Management involves discontinuing the product, rehydration, and monitoring of serum calcium levels. Severe cases may require hospitalization.
Pregnancy & Lactation
This medicine can be used during pregnancy and lactation to meet increased calcium and vitamin D requirements, but should be used under medical supervision and within recommended daily allowances.
Side Effects
Contraindications
- Hypercalcaemia (abnormally high levels of calcium in the blood).
- Hypercalciuria (excessive excretion of calcium in the urine).
- Nephrolithiasis (kidney stones) or history of kidney stones.
- Severe renal impairment.
- Hypersensitivity to the active substances or to any of the excipients.
Drug Interactions
Levothyroxine
Calcium can reduce the absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can impair the absorption of bisphosphonates. Take bisphosphonates at least 30 minutes before calcium.
Cardiac glycosides
Hypercalcaemia may potentiate the toxic effects of cardiac glycosides (e.g., digoxin), increasing the risk of arrhythmias.
Thiazide diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcaemia.
Phenytoin and Barbiturates
May reduce the effect of Vitamin D.
Tetracycline and Fluoroquinolone antibiotics
Oral calcium can reduce 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 include nausea, vomiting, constipation, severe thirst, polyuria, and fatigue. In severe cases, hypercalcaemia can lead to renal impairment and cardiac arrhythmias. Management involves discontinuing the product, rehydration, and monitoring of serum calcium levels. Severe cases may require hospitalization.
Pregnancy & Lactation
This medicine can be used during pregnancy and lactation to meet increased calcium and vitamin D requirements, but should be used under medical supervision and within recommended daily allowances.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the manufacturing date, check the packaging for exact expiry.
Availability
Pharmacies, drug stores, supermarkets
Approval Status
Approved by DGDA
Patent Status
Generic, expired
Clinical Trials
Calcium and Vitamin D supplementation is a well-established therapy. Numerous clinical trials support its efficacy in preventing and treating calcium/vitamin D deficiency and as an adjuvant in osteoporosis management. Specific trials for this exact formulation exist, demonstrating bioavailability and safety.
Lab Monitoring
- Serum calcium levels (especially in long-term use or renal impairment)
- Serum phosphate levels
- Urinary calcium excretion (if hypercalciuria is suspected)
Doctor Notes
- Assess patient's dietary calcium and vitamin D intake before recommending supplementation.
- Advise patients to report any symptoms of hypercalcaemia such as nausea, vomiting, or excessive thirst.
- Caution in patients with a history of renal calculi; monitor urinary calcium if concerns arise.
- Ensure proper dosing intervals when co-administering with interacting medications.
Patient Guidelines
- Do not exceed the recommended dose without consulting your doctor.
- Inform your doctor or pharmacist about all other medications, supplements, and herbal products you are taking.
- Maintain adequate fluid intake while taking this supplement.
- If you experience severe or persistent side effects, contact your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Calbo-D is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet rich in calcium (dairy products, leafy greens) and vitamin D (fatty fish, fortified foods).
- Engage in regular weight-bearing exercises to promote bone health.
- Moderate sun exposure can help the body produce vitamin D naturally.
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