Maxical-DX
Generic Name
Calcium Carbonate (Eq. to Elemental Calcium 600 mg) + Vitamin D3
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| maxical dx 600 mg tablet | ৳ 8.00 | ৳ 32.00 |
Description
Overview of the medicine
Maxical-DX 600 mg Tablet is a combination of Calcium Carbonate and Vitamin D3, used to prevent and treat calcium and vitamin D deficiencies, particularly in conditions like osteoporosis, osteomalacia, and during pregnancy and lactation.
Uses & Indications
Dosage
Adults
1-2 tablets daily, or as directed by physician. Should be taken with food for better absorption.
Elderly
No specific dose adjustment required unless renal impairment is present. Follow adult dosage.
Renal_impairment
Use with caution. Dosage adjustment may be required based on creatinine clearance and serum calcium/phosphate levels. Avoid in severe renal impairment.
How to Take
Oral administration. Tablets can be chewed or swallowed whole. Best taken with meals to enhance calcium absorption and minimize GI upset.
Mechanism of Action
Calcium Carbonate provides elemental calcium, essential for bone formation, muscle contraction, and nerve function. Vitamin D3 (Cholecalciferol) helps regulate calcium and phosphate homeostasis, promoting their absorption from the gut and deposition in bones.
Pharmacokinetics
Onset
Bone mineralization effects are gradual, over weeks to months. Blood calcium levels can increase within hours.
Excretion
Calcium: Primarily excreted via feces (unabsorbed) and urine (filtered). Vitamin D3 and its metabolites are excreted mainly via bile into feces, with some renal excretion.
Half life
Calcium: Varies. Vitamin D3: 19-48 hours (parent compound), active metabolites have longer half-lives (e.g., calcifediol ~16 days, calcitriol ~4-6 hours).
Absorption
Calcium absorption is approximately 20-30% from the small intestine, enhanced by Vitamin D3. Vitamin D3 is well absorbed from the GI tract.
Metabolism
Calcium is not metabolized. Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D3 (calcifediol) and then in the kidneys to 1,25-dihydroxyvitamin D3 (calcitriol), the active form.
Side Effects
Contraindications
- Hypersensitivity to Calcium Carbonate or Vitamin D3
- Hypercalcemia (high blood calcium levels)
- Severe hypercalciuria (high urine calcium levels)
- Nephrolithiasis (kidney stones)
- Hypervitaminosis D
Drug Interactions
Bisphosphonates
Calcium can interfere with absorption; separate administration by at least 30 minutes.
Cardiac glycosides
Increased risk of cardiac arrhythmias if hypercalcemia occurs.
Thiazide diuretics
May increase risk of hypercalcemia.
Tetracyclines & Quinolones
Calcium can decrease their absorption; separate administration by at least 2-3 hours.
Thyroid hormones (Levothyroxine)
Calcium can decrease their absorption; separate administration by at least 4 hours.
Phenytoin, Barbiturates, Glucocorticoids
May reduce Vitamin D activity.
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 hypercalcemia (nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, fatigue), hypervitaminosis D. Treatment involves discontinuing the product, hydration, and medical management of hypercalcemia.
Pregnancy & Lactation
Generally considered safe and often recommended during pregnancy and lactation to meet increased calcium and Vitamin D requirements. However, consult a physician before use to determine appropriate dosage.
Side Effects
Contraindications
- Hypersensitivity to Calcium Carbonate or Vitamin D3
- Hypercalcemia (high blood calcium levels)
- Severe hypercalciuria (high urine calcium levels)
- Nephrolithiasis (kidney stones)
- Hypervitaminosis D
Drug Interactions
Bisphosphonates
Calcium can interfere with absorption; separate administration by at least 30 minutes.
Cardiac glycosides
Increased risk of cardiac arrhythmias if hypercalcemia occurs.
Thiazide diuretics
May increase risk of hypercalcemia.
Tetracyclines & Quinolones
Calcium can decrease their absorption; separate administration by at least 2-3 hours.
Thyroid hormones (Levothyroxine)
Calcium can decrease their absorption; separate administration by at least 4 hours.
Phenytoin, Barbiturates, Glucocorticoids
May reduce Vitamin D activity.
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 hypercalcemia (nausea, vomiting, constipation, polyuria, polydipsia, muscle weakness, fatigue), hypervitaminosis D. Treatment involves discontinuing the product, hydration, and medical management of hypercalcemia.
Pregnancy & Lactation
Generally considered safe and often recommended during pregnancy and lactation to meet increased calcium and Vitamin D requirements. However, consult a physician before use to determine appropriate dosage.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Pharmacies, drugstores
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Off-patent
Clinical Trials
Extensive clinical trials support the efficacy and safety of calcium and Vitamin D supplementation in various patient populations for bone health and deficiency correction.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or on prolonged therapy)
- Serum phosphate levels
- 24-hour urinary calcium excretion
- Renal function (creatinine clearance)
Doctor Notes
- Advise patients to report any symptoms of hypercalcemia.
- Emphasize the importance of adequate fluid intake.
- Consider baseline and periodic monitoring of serum calcium, phosphate, and renal function in at-risk patients or those on prolonged therapy.
Patient Guidelines
- Take as directed by your doctor or pharmacist.
- Do not exceed the recommended dose.
- Take with food to minimize stomach upset and improve absorption.
- Drink plenty of fluids while taking this medication.
- Inform your doctor about all other medications and supplements you are taking.
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 double the dose.
Driving Precautions
Maxical-DX 600 mg Tablet is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet rich in calcium and vitamin D.
- Engage in regular weight-bearing exercises to improve bone health.
- Limit alcohol and caffeine intake.
- Avoid smoking.
- Get adequate sun exposure for natural Vitamin D synthesis.
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