Shelcal-DX
Generic Name
Calcium Carbonate (elemental 600 mg) + Vitamin D3 (Cholecalciferol 400 IU)
Manufacturer
Torrent Pharmaceuticals Ltd.
Country
India
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| shelcal dx 600 mg tablet | ৳ 17.00 | ৳ 170.00 |
Description
Overview of the medicine
Shelcal-DX 600 mg tablet is a combination medication containing calcium carbonate and vitamin D3 (cholecalciferol). It is primarily used to prevent and treat calcium and vitamin D deficiencies, which are essential for maintaining healthy bones and teeth and supporting various bodily functions.
Uses & Indications
Dosage
Adults
Typically one tablet daily, preferably with a meal, or as directed by physician. Dosage may vary based on individual needs and deficiency levels.
Elderly
Same as adults, but caution advised in renal impairment. Monitor calcium levels.
Renal_impairment
Use with caution and monitor calcium/phosphate levels; dosage adjustment may be necessary. Not recommended in severe renal impairment without medical supervision.
How to Take
Oral. The tablet can be swallowed whole with water. It is generally recommended to take it with a meal to enhance absorption and reduce potential gastric discomfort.
Mechanism of Action
Calcium carbonate provides elemental calcium, crucial for bone mineralization, muscle contraction, nerve transmission, and various metabolic processes. Vitamin D3 facilitates the absorption of calcium from the gut, helps maintain calcium and phosphate homeostasis, and supports bone health by promoting bone mineralization.
Pharmacokinetics
Onset
Therapeutic effects on bone mineral density are gradual and may take weeks to months.
Excretion
Calcium is excreted primarily via kidneys and feces. Vitamin D3 metabolites are primarily excreted in bile and feces.
Half life
Calcium: Variable, related to bone turnover. Vitamin D3 (Cholecalciferol): half-life of about 15 hours, its active metabolite (calcitriol) has a half-life of several days.
Absorption
Calcium carbonate is absorbed in the small intestine, with absorption enhanced by vitamin D. Cholecalciferol is absorbed in the small intestine, primarily via the lymphatic system.
Metabolism
Calcium is not metabolized in the traditional sense, but its levels are regulated. Cholecalciferol is hydroxylated in the liver to 25-hydroxyvitamin D3 and then in the kidneys to 1,25-dihydroxyvitamin D3 (calcitriol, the active form).
Side Effects
Contraindications
- Hypersensitivity to calcium carbonate, cholecalciferol, or any excipients
- Hypercalcaemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Kidney stones (nephrolithiasis) or history of kidney stones
- Hypervitaminosis D (excess vitamin D levels)
Drug Interactions
Digoxin
Hypercalcaemia may increase the risk of digoxin toxicity.
Bisphosphonates
Calcium can interfere with absorption. Administer calcium at least 30 minutes after bisphosphonates.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion.
Thiazide diuretics
May reduce calcium excretion and increase risk of hypercalcaemia.
Tetracyclines and Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Take calcium at least 2 hours before or 4-6 hours after.
Thyroid hormones (e.g., Levothyroxine)
Calcium can reduce absorption of thyroid hormones. Separate administration by at least 4 hours.
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 (hypercalcaemia) include nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria, polydipsia, and in severe cases, cardiac arrhythmias and coma. Treatment involves discontinuation of the supplement, hydration, and medical management of hypercalcaemia.
Pregnancy & Lactation
Generally considered safe and often recommended during pregnancy and lactation for adequate calcium and vitamin D intake, especially under medical supervision to avoid exceeding recommended daily allowances.
Side Effects
Contraindications
- Hypersensitivity to calcium carbonate, cholecalciferol, or any excipients
- Hypercalcaemia (high levels of calcium in the blood)
- Hypercalciuria (high levels of calcium in the urine)
- Severe renal impairment
- Kidney stones (nephrolithiasis) or history of kidney stones
- Hypervitaminosis D (excess vitamin D levels)
Drug Interactions
Digoxin
Hypercalcaemia may increase the risk of digoxin toxicity.
Bisphosphonates
Calcium can interfere with absorption. Administer calcium at least 30 minutes after bisphosphonates.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion.
Thiazide diuretics
May reduce calcium excretion and increase risk of hypercalcaemia.
Tetracyclines and Fluoroquinolones
Calcium can chelate these antibiotics, reducing their absorption. Take calcium at least 2 hours before or 4-6 hours after.
Thyroid hormones (e.g., Levothyroxine)
Calcium can reduce absorption of thyroid hormones. Separate administration by at least 4 hours.
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 (hypercalcaemia) include nausea, vomiting, constipation, abdominal pain, muscle weakness, polyuria, polydipsia, and in severe cases, cardiac arrhythmias and coma. Treatment involves discontinuation of the supplement, hydration, and medical management of hypercalcaemia.
Pregnancy & Lactation
Generally considered safe and often recommended during pregnancy and lactation for adequate calcium and vitamin D intake, especially under medical supervision to avoid exceeding recommended daily allowances.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Check specific packaging for exact expiry.
Availability
Pharmacies, drugstores, online pharmacies
Approval Status
Approved by regulatory bodies (e.g., DGDA in Bangladesh, FDA in other regions)
Patent Status
Generic/Off-patent
Clinical Trials
Numerous clinical trials support the efficacy of calcium and vitamin D supplementation in preventing and treating bone disorders, particularly osteoporosis, in various populations.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or those on prolonged high doses)
- Serum vitamin D levels (25-hydroxyvitamin D)
- Renal function tests (creatinine, eGFR)
Doctor Notes
- Advise patients on the importance of adhering to prescribed dosage and not self-increasing.
- Counsel on dietary sources of calcium and vitamin D.
- Monitor serum calcium and renal function in patients with pre-existing conditions or on concomitant medications.
- Caution in patients with a history of kidney stones.
Patient Guidelines
- Take as directed by your doctor or pharmacist.
- Do not exceed the recommended dose.
- Inform your doctor about all other medications you are taking.
- Maintain adequate fluid intake.
- Report any unusual symptoms or side effects to your doctor.
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 to catch up.
Driving Precautions
Shelcal-DX 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 exercise to support bone health.
- Ensure adequate sun exposure for natural vitamin D synthesis (but protect against excessive UV).
- Avoid smoking and excessive alcohol consumption, as these can negatively impact bone density.
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