Calbo-Forte
Generic Name
Calcium Carbonate & Vitamin D3
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| calbo forte 1000 mg tablet | ৳ 8.06 | N/A |
Description
Overview of the medicine
Calbo-Forte 1000 mg Tablet is a combination supplement of Calcium Carbonate and Vitamin D3, primarily used to prevent and treat calcium and vitamin D deficiencies and support bone health, particularly in conditions like osteoporosis.
Uses & Indications
Dosage
Adults
1 tablet once or twice daily, or as directed by physician. It is usually recommended to take with meals.
Elderly
Same as adults; however, caution is advised in elderly patients with impaired renal function. Monitor serum calcium and creatinine levels.
Renal_impairment
Use with caution. Dosage adjustments may be necessary based on serum calcium and phosphate levels. Avoid in severe renal impairment.
How to Take
Calbo-Forte 1000 mg Tablet should be swallowed whole with a glass of water, preferably with or immediately after food to enhance absorption and minimize gastrointestinal upset.
Mechanism of Action
Calcium is an essential mineral required for bone formation, maintenance, and various metabolic processes. Vitamin D3 (Cholecalciferol) plays a crucial role in regulating calcium and phosphate homeostasis, promoting their absorption from the gut and mineralization of bone.
Pharmacokinetics
Onset
Clinical effects on bone density are gradual, observable over several weeks to months of continuous use.
Excretion
Unabsorbed calcium is excreted via feces; absorbed calcium is primarily excreted renally. Vitamin D3 metabolites are mainly excreted in bile and feces, with a minor portion excreted renally.
Half life
The half-life of Vitamin D3 (cholecalciferol) is approximately 15-20 hours, while its active metabolite, calcitriol, has a half-life of 3-5 days. Calcium has a complex physiological turnover.
Absorption
Calcium absorption from Calcium Carbonate occurs primarily in the small intestine, enhanced significantly by the presence of Vitamin D3. Oral Vitamin D3 is well absorbed.
Metabolism
Calcium is not metabolized. Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D3 (calcifediol) and then in the kidneys to the active form, 1,25-dihydroxyvitamin D3 (calcitriol).
Side Effects
Contraindications
- Hypersensitivity to Calcium Carbonate, Vitamin D3, or any component of the formulation
- Hypercalcemia (abnormally high levels of calcium in the blood)
- Severe hypercalciuria (excessive calcium in the urine)
- Severe renal impairment or renal calculus formation
- Primary hyperparathyroidism
- Vitamin D intoxication
Drug Interactions
Corticosteroids
May reduce calcium absorption and increase calcium excretion.
Thiazide Diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcemia.
Digitalis Glycosides
Hypercalcemia can potentiate the effects of digitalis, leading to cardiac arrhythmias.
Tetracyclines & Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Administer calcium at least 2-3 hours before or 4-6 hours after these antibiotics.
Thyroid Hormones (e.g., Levothyroxine)
Calcium can impair the absorption of thyroid hormones. Administer thyroid hormones at least 4 hours apart from 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 primarily involve hypercalcemia (nausea, vomiting, constipation, thirst, polyuria, muscle weakness, confusion, fatigue). Severe cases can lead to renal impairment and cardiac arrhythmias. Management includes immediate discontinuation of the drug, rehydration, and supportive care. In severe cases, intravenous fluids, loop diuretics, and corticosteroids may be necessary.
Pregnancy & Lactation
Calbo-Forte 1000 mg Tablet is generally considered safe and beneficial during pregnancy and lactation at recommended doses, as calcium and Vitamin D requirements increase. However, excessive doses should be avoided, and use should always be under medical supervision.
Side Effects
Contraindications
- Hypersensitivity to Calcium Carbonate, Vitamin D3, or any component of the formulation
- Hypercalcemia (abnormally high levels of calcium in the blood)
- Severe hypercalciuria (excessive calcium in the urine)
- Severe renal impairment or renal calculus formation
- Primary hyperparathyroidism
- Vitamin D intoxication
Drug Interactions
Corticosteroids
May reduce calcium absorption and increase calcium excretion.
Thiazide Diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcemia.
Digitalis Glycosides
Hypercalcemia can potentiate the effects of digitalis, leading to cardiac arrhythmias.
Tetracyclines & Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Administer calcium at least 2-3 hours before or 4-6 hours after these antibiotics.
Thyroid Hormones (e.g., Levothyroxine)
Calcium can impair the absorption of thyroid hormones. Administer thyroid hormones at least 4 hours apart from 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 primarily involve hypercalcemia (nausea, vomiting, constipation, thirst, polyuria, muscle weakness, confusion, fatigue). Severe cases can lead to renal impairment and cardiac arrhythmias. Management includes immediate discontinuation of the drug, rehydration, and supportive care. In severe cases, intravenous fluids, loop diuretics, and corticosteroids may be necessary.
Pregnancy & Lactation
Calbo-Forte 1000 mg Tablet is generally considered safe and beneficial during pregnancy and lactation at recommended doses, as calcium and Vitamin D requirements increase. However, excessive doses should be avoided, and use should always be under medical supervision.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 36 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies, drugstores
Approval Status
Approved
Patent Status
Expired
Clinical Trials
Calcium and Vitamin D supplementation have been extensively studied in numerous clinical trials supporting their efficacy in preventing and treating bone-related disorders, particularly osteoporosis. Specific trials for Calbo-Forte, as a generic combination, typically refer to bioequivalence and safety studies.
Lab Monitoring
- Serum calcium levels (especially for long-term therapy, renal impairment, or high doses)
- Renal function (creatinine, eGFR) at regular intervals
- Urinary calcium excretion (if there is a risk of hypercalciuria or renal stones)
Doctor Notes
- Ensure to assess the patient's baseline calcium and Vitamin D levels, especially in at-risk populations.
- Educate patients on proper dosing and potential interactions with other medications and foods.
- Advise patients with a history of kidney stones or renal impairment to take this supplement under strict medical supervision with regular monitoring.
Patient Guidelines
- Take the tablet with a full glass of water. It can be taken with or without food, but food may reduce gastrointestinal upset.
- Do not exceed the recommended daily dose unless specifically advised by your healthcare provider.
- Inform your doctor or pharmacist about all other medications, including over-the-counter drugs, herbal supplements, and vitamins, to avoid potential interactions.
- Report any unusual or severe side effects to your doctor immediately.
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 usual dosing schedule. Do not double the dose to catch up.
Driving Precautions
Calbo-Forte 1000 mg Tablet is not known to affect the ability to drive or operate machinery. No specific precautions are necessary.
Lifestyle Advice
- Maintain a balanced diet rich in calcium from food sources like dairy products, leafy green vegetables, and fortified foods.
- Engage in regular weight-bearing exercise, such as walking or jogging, to support bone health.
- Ensure adequate but safe sun exposure for natural Vitamin D synthesis. If sun exposure is limited, discuss additional Vitamin D sources with your doctor.
- Limit excessive intake of alcohol and caffeine, which can negatively impact calcium absorption.
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