Myocal-D
Generic Name
Calcium Carbonate + Cholecalciferol (Vitamin D3)
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| myocal d 500 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Myocal-D 500 mg Tablet is a combination of Calcium Carbonate and Cholecalciferol (Vitamin D3), used to treat and prevent calcium and vitamin D deficiencies, particularly in conditions like osteoporosis, rickets, and osteomalacia.
Uses & Indications
Dosage
Adults
1-2 tablets daily, or as directed by physician. May be taken with or without food.
Elderly
Same as adult dosage, but may require closer monitoring for hypercalcemia.
Renal_impairment
Use with caution. Dosage adjustment may be required based on creatinine clearance and serum calcium levels. Avoid in severe renal impairment.
How to Take
Orally, preferably with meals to enhance absorption. Chewable tablets should be chewed before swallowing.
Mechanism of Action
Calcium Carbonate provides essential calcium for bone formation, nerve transmission, muscle contraction, and various metabolic functions. Cholecalciferol (Vitamin D3) helps regulate calcium and phosphate homeostasis, promoting their absorption from the gut and deposition into bones.
Pharmacokinetics
Onset
Nutritional effects are gradual, over days to weeks.
Excretion
Unabsorbed calcium is excreted in feces. Absorbed calcium is excreted mainly via kidneys and some via bile. Vitamin D metabolites are excreted primarily in bile and feces.
Half life
Calcium half-life varies. Vitamin D3 has a half-life of about 15-20 days, but active metabolites can persist longer.
Absorption
Calcium is absorbed primarily in the small intestine, about 20-30% of ingested calcium. Vitamin D3 is absorbed from the small intestine, transported to the liver, and then to the kidneys where it's converted to its active form, calcitriol.
Metabolism
Calcium is not metabolized. Vitamin D3 is hydroxylated in the liver (to 25-hydroxyvitamin D) and then in the kidneys (to 1,25-dihydroxyvitamin D, calcitriol, the active form).
Side Effects
Contraindications
- Hypersensitivity to the active substances or excipients
- Hypercalcemia (high levels of calcium in blood)
- Hypercalciuria (high levels of calcium in urine)
- Severe renal impairment or renal stones
- Primary hyperparathyroidism
- Hypervitaminosis D
Drug Interactions
Levothyroxine
Calcium can impair absorption; separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption; separate administration by at least 30 minutes.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion.
Iron supplements
Calcium may decrease iron absorption; separate administration by at least 2-3 hours.
Thiazide diuretics
May increase risk of hypercalcemia by decreasing urinary calcium excretion.
Tetracyclines & Fluoroquinolones
Calcium can reduce absorption; separate administration by at least 2-3 hours.
Storage
Store in a cool and 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, abdominal pain, muscle weakness, polyuria, polydipsia, fatigue, confusion). Severe cases can lead to renal impairment and cardiac arrhythmias. Treatment involves discontinuing the supplement, hydration, and medical management of hypercalcemia.
Pregnancy & Lactation
Generally considered safe within recommended daily allowances during pregnancy and lactation. Consult a doctor to determine appropriate dosage to avoid hypercalcemia in the mother or infant.
Side Effects
Contraindications
- Hypersensitivity to the active substances or excipients
- Hypercalcemia (high levels of calcium in blood)
- Hypercalciuria (high levels of calcium in urine)
- Severe renal impairment or renal stones
- Primary hyperparathyroidism
- Hypervitaminosis D
Drug Interactions
Levothyroxine
Calcium can impair absorption; separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption; separate administration by at least 30 minutes.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion.
Iron supplements
Calcium may decrease iron absorption; separate administration by at least 2-3 hours.
Thiazide diuretics
May increase risk of hypercalcemia by decreasing urinary calcium excretion.
Tetracyclines & Fluoroquinolones
Calcium can reduce absorption; separate administration by at least 2-3 hours.
Storage
Store in a cool and 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, abdominal pain, muscle weakness, polyuria, polydipsia, fatigue, confusion). Severe cases can lead to renal impairment and cardiac arrhythmias. Treatment involves discontinuing the supplement, hydration, and medical management of hypercalcemia.
Pregnancy & Lactation
Generally considered safe within recommended daily allowances during pregnancy and lactation. Consult a doctor to determine appropriate dosage to avoid hypercalcemia in the mother or infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, drug stores
Approval Status
Approved (typically OTC or prescription)
Patent Status
Generic, widely available
Clinical Trials
Numerous clinical trials have established the efficacy of calcium and vitamin D supplementation in preventing and treating bone disorders, particularly osteoporosis.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or on prolonged treatment)
- Urinary calcium excretion (if hypercalciuria is suspected)
- Renal function tests (e.g., creatinine, eGFR)
Doctor Notes
- Advise patients on dietary sources of calcium and vitamin D.
- Monitor serum calcium levels, especially in patients with renal impairment or those concurrently taking thiazide diuretics.
- Emphasize the importance of adequate fluid intake to minimize the risk of kidney stone formation.
Patient Guidelines
- Take exactly as prescribed or directed on the label.
- Do not exceed the recommended dose.
- Report any signs of hypercalcemia (e.g., nausea, vomiting, unusual tiredness, increased urination) to your doctor.
- Maintain adequate fluid intake.
Missed Dose Advice
If a dose is missed, 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
Myocal-D is not known to affect the ability to drive or operate machinery. If you experience dizziness or fatigue, avoid driving.
Lifestyle Advice
- Engage in regular weight-bearing exercise to support bone health.
- Ensure a balanced diet rich in calcium and vitamin D.
- Limit consumption of sodium, caffeine, and alcohol, which can negatively impact calcium balance.
- Get moderate sunlight exposure for natural vitamin D synthesis, while practicing sun safety.
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