Adults

1-2 tablets daily, preferably with or after meals, or as directed by a physician.

Elderly

1-2 tablets daily, or as directed by a physician.

Renal_impairment

Use with caution and monitor calcium levels. Dosage adjustment may be required.

Onset

Gradual; significant effects on bone density typically seen after weeks to months of continuous use.

Excretion

Primarily renal excretion for calcium, magnesium, and zinc; some biliary and fecal excretion for vitamin D3 metabolites.

Half life

Vitamin D3 has a relatively long half-life (several weeks), while calcium, magnesium, and zinc ions are rapidly cleared or incorporated.

Absorption

Calcium and Vitamin D3 are primarily absorbed in the small intestine. Magnesium and Zinc are also absorbed from the gastrointestinal tract.

Metabolism

Vitamin D3 is hydroxylated in the liver and kidneys to its active form. Calcium, magnesium, and zinc are primarily utilized as ions and are not extensively metabolized.

Bisphosphonates

Reduced absorption if taken concurrently. Separate administration by at least 30 minutes to 2 hours.

Thiazide Diuretics

May reduce urinary calcium excretion, potentially leading to hypercalcemia.

Tetracyclines & Fluoroquinolones

Calcium, magnesium, and zinc can chelate with these antibiotics, reducing their absorption. Administer at least 2-4 hours apart.

Cardiac Glycosides (e.g., Digoxin)

Hypercalcemia can potentiate the effects of cardiac glycosides, increasing the risk of toxicity.

Thyroid Hormones (e.g., Levothyroxine)

Calcium can interfere with the absorption of thyroid hormones. Administer at least 4 hours apart.