Carbocal-D
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 |
|---|---|---|
| carbocal d 500 mg tablet | ৳ 7.00 | ৳ 42.00 |
Description
Overview of the medicine
Carbocal-D 500 mg Tablet is a combination of Calcium Carbonate and Vitamin D3 (Cholecalciferol) used to prevent or treat calcium and vitamin D deficiencies. It is primarily used to maintain bone health, especially in conditions like osteoporosis, osteomalacia, and during pregnancy and lactation.
Uses & Indications
Dosage
Adults
Typically 1-2 tablets daily, or as directed by the physician. Should be taken with a meal.
Elderly
No specific dose adjustment required, but caution in patients with renal impairment is advised.
Renal_impairment
Use with caution and monitor calcium levels. Dose adjustment or avoidance may be necessary in severe renal impairment. Consult a physician.
How to Take
Take orally, preferably with a meal to enhance absorption and reduce gastrointestinal upset. Swallow the tablet whole with a glass of water. Do not crush or chew unless it is a chewable tablet formulation.
Mechanism of Action
Calcium Carbonate provides elemental calcium which is essential for bone formation, nerve transmission, muscle contraction, and blood clotting. Vitamin D3 helps regulate calcium and phosphate homeostasis, promoting their absorption from the gut and mineralization of bone. It also plays a role in immune function.
Pharmacokinetics
Onset
Therapeutic effects on bone mineral density develop gradually over weeks to months.
Excretion
Unabsorbed calcium is excreted in feces. Absorbed calcium is primarily excreted via the kidneys (urine) and to a lesser extent via feces and sweat. Vitamin D metabolites are primarily excreted in bile and feces.
Half life
The elimination half-life of Vitamin D3 (cholecalciferol) is approximately 19-25 hours, but its active metabolite calcitriol has a longer duration of action. Calcium kinetics are complex and depend on various physiological processes.
Absorption
Calcium Carbonate is absorbed from the gastrointestinal tract, with absorption enhanced by Vitamin D. Vitamin D3 is absorbed from the small intestine, primarily in the presence of bile salts. Approximately 20-30% of ingested calcium is absorbed.
Metabolism
Calcium is not metabolized. Vitamin D3 is hydroxylated in the liver to 25-hydroxycholecalciferol (calcidiol) and further in the kidneys to 1,25-dihydroxycholecalciferol (calcitriol), its active form.
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 (abnormally high levels of calcium in the urine)
- Nephrolithiasis (kidney stones)
- Severe renal impairment
- Hypervitaminosis D
Drug Interactions
Bisphosphonates
Calcium can interfere with the absorption of bisphosphonates. Administer calcium at least 30 minutes (preferably 1-2 hours) after bisphosphonates.
Corticosteroids
May reduce calcium absorption.
Thiazide Diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcemia.
Tetracyclines & Fluoroquinolones
Calcium can decrease the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after calcium supplements.
Cardiac Glycosides (e.g., Digoxin)
Hypercalcemia can potentiate the effects of cardiac glycosides, increasing the risk of arrhythmias.
Thyroid Hormones (e.g., Levothyroxine)
Calcium can reduce the absorption of thyroid hormones. Separate administration by at least 4 hours.
Storage
Store in a cool (below 30°C), dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, polydipsia, polyuria, anorexia, and in severe cases, cardiac arrhythmias and renal impairment. Management involves discontinuing the supplement, hydrating the patient, and managing symptoms. Seek immediate medical attention.
Pregnancy & Lactation
Carbocal-D is often indicated and generally considered safe during pregnancy and lactation to meet increased calcium and vitamin D requirements. However, consult your doctor for appropriate dosage and to avoid excessive intake, as hypercalcemia can be harmful to the fetus/infant.
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 (abnormally high levels of calcium in the urine)
- Nephrolithiasis (kidney stones)
- Severe renal impairment
- Hypervitaminosis D
Drug Interactions
Bisphosphonates
Calcium can interfere with the absorption of bisphosphonates. Administer calcium at least 30 minutes (preferably 1-2 hours) after bisphosphonates.
Corticosteroids
May reduce calcium absorption.
Thiazide Diuretics
May reduce urinary excretion of calcium, increasing the risk of hypercalcemia.
Tetracyclines & Fluoroquinolones
Calcium can decrease the absorption of these antibiotics. Administer at least 2 hours before or 4-6 hours after calcium supplements.
Cardiac Glycosides (e.g., Digoxin)
Hypercalcemia can potentiate the effects of cardiac glycosides, increasing the risk of arrhythmias.
Thyroid Hormones (e.g., Levothyroxine)
Calcium can reduce the absorption of thyroid hormones. Separate administration by at least 4 hours.
Storage
Store in a cool (below 30°C), dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, polydipsia, polyuria, anorexia, and in severe cases, cardiac arrhythmias and renal impairment. Management involves discontinuing the supplement, hydrating the patient, and managing symptoms. Seek immediate medical attention.
Pregnancy & Lactation
Carbocal-D is often indicated and generally considered safe during pregnancy and lactation to meet increased calcium and vitamin D requirements. However, consult your doctor for appropriate dosage and to avoid excessive intake, as hypercalcemia can be harmful to the fetus/infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2 years from manufacturing date.
Availability
Pharmacies, drugstores
Approval Status
Approved
Patent Status
Generic
Clinical Trials
Calcium and Vitamin D combinations have been extensively studied over decades for their efficacy in bone health, osteoporosis prevention, and fracture reduction. Numerous clinical trials support their role in these indications.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or on long-term therapy)
- Serum 25-hydroxyvitamin D levels
- Renal function tests (e.g., serum creatinine, BUN)
Doctor Notes
- Advise patients on dietary sources of calcium and vitamin D.
- Monitor serum calcium and vitamin D levels periodically, especially in high-risk patients.
- Caution in patients with a history of nephrolithiasis or renal impairment.
- Review concomitant medications for potential interactions.
Patient Guidelines
- Take exactly as prescribed by your doctor or as indicated on the label.
- Do not exceed the recommended dose without consulting a healthcare professional.
- Report any unusual or severe side effects to your doctor.
- Ensure adequate fluid intake throughout the day.
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 double the dose to catch up.
Driving Precautions
Carbocal-D 500 mg Tablet is generally not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or severe fatigue, avoid these activities.
Lifestyle Advice
- Maintain a balanced diet rich in calcium and vitamin D.
- Engage in regular weight-bearing exercises to support bone health.
- Adequate sun exposure can help with natural vitamin D synthesis, but avoid excessive unprotected exposure.
- Limit consumption of alcohol and caffeine.
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