Rocal-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 |
|---|---|---|
| rocal d 500 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Rocal-D is a combination medication containing Calcium Carbonate and Vitamin D3. It is primarily used to prevent and treat calcium and vitamin D deficiencies, which are crucial for bone health, muscle function, and overall well-being. Calcium is a vital mineral for strong bones and teeth, while Vitamin D3 helps the body absorb calcium and phosphorus.
Uses & Indications
Dosage
Adults
Typically, 1-2 tablets daily, or as directed by a physician. Doses vary based on calcium/D3 content.
Elderly
Same as adults, but may require closer monitoring for hypercalcemia.
Renal_impairment
Caution advised; dose adjustment may be necessary. Avoid if severe hypercalcemia or hypercalciuria present.
How to Take
Oral administration. Tablets can be taken with or without food. Chewable tablets should be chewed thoroughly before swallowing.
Mechanism of Action
Calcium Carbonate provides an exogenous source of calcium. Vitamin D3 (Cholecalciferol) is a fat-soluble vitamin that plays a critical role in calcium and phosphate homeostasis. It promotes calcium absorption from the gut, reabsorption in the kidneys, and bone mineralization. It also regulates parathyroid hormone (PTH) levels.
Pharmacokinetics
Onset
Not acutely applicable for a supplement; long-term effect for bone health.
Excretion
Calcium is excreted mainly via feces (unabsorbed) and urine (excess absorbed). Vitamin D metabolites are primarily excreted in bile and feces, with a small amount in urine.
Half life
Calcium: Variable, depends on physiological needs. Vitamin D3: The half-life of 25(OH)D3 (calcifediol) is about 15 days, and 1,25(OH)2D3 (calcitriol) is about 4-6 hours.
Absorption
Calcium carbonate is absorbed in the small intestine, primarily in the duodenum, via active transport and passive diffusion. Absorption is enhanced by Vitamin D. Vitamin D3 is well absorbed from the gastrointestinal tract in the presence of bile.
Metabolism
Calcium is not metabolized in the traditional sense. Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D (calcifediol) and then in the kidneys to 1,25-dihydroxyvitamin D (calcitriol), its active form.
Side Effects
Contraindications
- Hypersensitivity to any component
- Hypercalcemia
- Severe hypercalciuria
- Primary hyperparathyroidism
- Nephrolithiasis
- Severe renal impairment
- Sarcoidosis (due to risk of hypercalcemia)
Drug Interactions
Levothyroxine
Calcium can reduce levothyroxine absorption. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption of bisphosphonates. Administer calcium at least 30 minutes (preferably longer) after bisphosphonates.
Corticosteroids
May reduce calcium absorption.
Thiazide diuretics
May increase the risk of hypercalcemia by decreasing urinary calcium excretion.
Digitalis glycosides
Hypercalcemia can potentiate the effects of digitalis, leading to cardiac arrhythmias.
Phenytoin, Barbiturates
May reduce Vitamin D effectiveness.
Tetracyclines & Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Administer calcium at least 2-3 hours before or 4-6 hours after these antibiotics.
Storage
Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) include nausea, vomiting, constipation, thirst, polyuria, muscle weakness, and confusion. Severe hypercalcemia can lead to renal impairment and cardiac arrhythmias. Management involves discontinuing the supplement, 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, but should be taken under medical supervision and within recommended daily allowances.
Side Effects
Contraindications
- Hypersensitivity to any component
- Hypercalcemia
- Severe hypercalciuria
- Primary hyperparathyroidism
- Nephrolithiasis
- Severe renal impairment
- Sarcoidosis (due to risk of hypercalcemia)
Drug Interactions
Levothyroxine
Calcium can reduce levothyroxine absorption. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption of bisphosphonates. Administer calcium at least 30 minutes (preferably longer) after bisphosphonates.
Corticosteroids
May reduce calcium absorption.
Thiazide diuretics
May increase the risk of hypercalcemia by decreasing urinary calcium excretion.
Digitalis glycosides
Hypercalcemia can potentiate the effects of digitalis, leading to cardiac arrhythmias.
Phenytoin, Barbiturates
May reduce Vitamin D effectiveness.
Tetracyclines & Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Administer calcium at least 2-3 hours before or 4-6 hours after these antibiotics.
Storage
Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) include nausea, vomiting, constipation, thirst, polyuria, muscle weakness, and confusion. Severe hypercalcemia can lead to renal impairment and cardiac arrhythmias. Management involves discontinuing the supplement, 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, but should be taken under medical supervision and within recommended daily allowances.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
Clinical Trials
Extensive clinical trials support the efficacy of calcium and vitamin D supplementation in preventing and treating bone-related disorders, including osteoporosis and deficiency states.
Lab Monitoring
- Serum calcium levels (especially for long-term therapy or high doses)
- Serum phosphate levels
- Renal function (creatinine, BUN)
- Urinary calcium excretion (if hypercalciuria suspected)
Doctor Notes
- Assess patient's baseline calcium and Vitamin D levels before starting therapy.
- Monitor serum calcium and renal function periodically in patients on long-term therapy or with renal impairment.
- Advise patients on potential drug interactions, especially with antibiotics and thyroid hormones.
Patient Guidelines
- Take as directed by your doctor or pharmacist.
- Do not exceed the recommended dose.
- Chew chewable tablets thoroughly before swallowing.
- Maintain a balanced diet rich in calcium and Vitamin D.
- Inform your doctor about all other medications you are taking.
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.
Driving Precautions
Rocal-D is generally not expected to affect the ability to drive or operate machinery.
Lifestyle Advice
- Regular weight-bearing exercise helps strengthen bones.
- Ensure adequate sun exposure for natural Vitamin D synthesis.
- Avoid smoking and excessive alcohol consumption, as these can negatively impact bone health.
- Maintain a healthy diet to support overall bone health.
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