Renocal-Plus
Generic Name
Calcium Carbonate (Elemental Calcium) + Cholecalciferol (Vitamin D3)
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| renocal plus 435 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Renocal-Plus 435 mg Tablet is a combination medicine containing elemental calcium and Vitamin D3. It is used to treat or prevent calcium deficiency, particularly in conditions like osteoporosis, osteomalacia, or hypocalcemia, often associated with chronic kidney disease.
Uses & Indications
Dosage
Adults
Typically, 1 tablet once or twice daily, or as directed by a physician. Should be taken with food.
Elderly
Same as adults, but caution should be exercised and calcium/Vitamin D levels monitored due to potential for impaired renal function.
Renal_impairment
Use with caution and monitor serum calcium and phosphate levels closely. Dose adjustment may be necessary. Not recommended in severe unmonitored renal impairment.
How to Take
Take the tablet orally, preferably with a meal to enhance absorption. Swallow the tablet whole with a glass of water; do not chew or crush it.
Mechanism of Action
Calcium Carbonate provides essential calcium ions for bone formation, nerve transmission, muscle contraction, and blood clotting. Cholecalciferol (Vitamin D3) enhances the absorption of calcium from the gastrointestinal tract and regulates calcium and phosphate homeostasis, facilitating bone mineralization.
Pharmacokinetics
Onset
Therapeutic effects are typically gradual and become evident with long-term consistent use.
Excretion
Calcium is primarily excreted via feces, with a smaller amount eliminated renally. Vitamin D metabolites are primarily excreted in bile and feces, with some renal elimination.
Half life
The half-life of calcium in the body is complex and varies. Vitamin D3 and its active metabolites have a prolonged half-life, ranging from days to weeks.
Absorption
Calcium absorption from the gastrointestinal tract is variable and depends on factors like dose, dietary intake, and Vitamin D status. Cholecalciferol is readily absorbed from the small intestine, especially in the presence of bile salts.
Metabolism
Calcium is not metabolized. Cholecalciferol is hydroxylated in the liver to 25-hydroxycholecalciferol and then in the kidneys to the active form, 1,25-dihydroxycholecalciferol (calcitriol).
Side Effects
Contraindications
- Hypersensitivity to the active substances or to any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Severe hypercalciuria (high levels of calcium in the urine)
- Nephrolithiasis (kidney stones)
- Severe renal impairment (unless on dialysis and under strict medical supervision)
- Vitamin D overdose
Drug Interactions
Levothyroxine
Calcium can reduce absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Reduced absorption of bisphosphonates. Take calcium at least 30 minutes after bisphosphonates.
Iron supplements
Calcium may interfere with iron absorption. Take at different times.
Thiazide diuretics
May decrease urinary calcium excretion, increasing the risk of hypercalcemia.
Tetracyclines & Fluoroquinolones
Calcium can reduce the absorption of these antibiotics. Administer at least 2-3 hours before or 4-6 hours after calcium.
Digitalis glycosides (e.g., Digoxin)
Hypercalcemia increases the risk of digitalis toxicity; monitor ECG and serum calcium.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbances, polydipsia (excessive thirst), polyuria (excessive urination), bone pain, and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing calcium/Vitamin D, rehydration, and supportive measures. Consult a physician immediately.
Pregnancy & Lactation
Renocal-Plus can be used during pregnancy and lactation if a physician determines it is necessary and beneficial, usually at recommended doses. Excessive intake should be avoided. Consult your doctor before use.
Side Effects
Contraindications
- Hypersensitivity to the active substances or to any of the excipients
- Hypercalcemia (high levels of calcium in the blood)
- Severe hypercalciuria (high levels of calcium in the urine)
- Nephrolithiasis (kidney stones)
- Severe renal impairment (unless on dialysis and under strict medical supervision)
- Vitamin D overdose
Drug Interactions
Levothyroxine
Calcium can reduce absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Reduced absorption of bisphosphonates. Take calcium at least 30 minutes after bisphosphonates.
Iron supplements
Calcium may interfere with iron absorption. Take at different times.
Thiazide diuretics
May decrease urinary calcium excretion, increasing the risk of hypercalcemia.
Tetracyclines & Fluoroquinolones
Calcium can reduce the absorption of these antibiotics. Administer at least 2-3 hours before or 4-6 hours after calcium.
Digitalis glycosides (e.g., Digoxin)
Hypercalcemia increases the risk of digitalis toxicity; monitor ECG and serum calcium.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbances, polydipsia (excessive thirst), polyuria (excessive urination), bone pain, and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing calcium/Vitamin D, rehydration, and supportive measures. Consult a physician immediately.
Pregnancy & Lactation
Renocal-Plus can be used during pregnancy and lactation if a physician determines it is necessary and beneficial, usually at recommended doses. Excessive intake should be avoided. Consult your doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, refer to product packaging for exact date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA
Patent Status
Generic
Clinical Trials
Specific clinical trials for Renocal-Plus 435 mg Tablet would focus on its efficacy and safety profile, often including bioequivalence studies for generic formulations.
Lab Monitoring
- Serum calcium levels (regularly, especially in renal impairment)
- Serum phosphate levels (in renal impairment)
- 25-hydroxyvitamin D levels
- Renal function tests (creatinine, GFR)
- Urinary calcium excretion (if hypercalciuria suspected)
Doctor Notes
- Emphasize monitoring serum calcium, phosphate, and Vitamin D levels, especially in patients with chronic kidney disease.
- Counsel patients on potential drug interactions, particularly with antibiotics and thyroid hormones.
- Advise patients about lifestyle modifications (diet, exercise) to maximize bone health benefits.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not exceed the recommended dose without consulting your physician.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Maintain a balanced diet and adequate fluid intake.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Renocal-Plus 435 mg Tablet is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Engage in regular weight-bearing exercises to support bone health.
- Ensure adequate sun exposure for natural Vitamin D synthesis, where appropriate.
- Avoid excessive alcohol and smoking, as they can negatively impact bone density.
- Limit intake of foods that may hinder calcium absorption (e.g., excessive oxalates, phytates).
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