Xtracal-D
Generic Name
Calcium Carbonate + Cholecalciferol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xtracal d 500 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Xtracal-D 500 mg Tablet is a combination of Calcium Carbonate and Vitamin D3, primarily used to treat and prevent calcium and vitamin D deficiencies, promoting bone health.
Uses & Indications
Dosage
Adults
Typically, 1-2 tablets daily, preferably with meals, or as directed by a physician.
Elderly
Same as adults, but caution is advised in patients with impaired renal function, and calcium/Vitamin D levels should be monitored.
Renal_impairment
Use with caution. Dosage adjustment may be required, and regular monitoring of serum calcium and phosphate levels is essential to avoid hypercalcemia and hyperphosphatemia.
How to Take
The tablet should be swallowed whole with water. It can be taken with or without food, though taking it with food may reduce gastrointestinal upset. Do not chew or crush the tablet.
Mechanism of Action
Calcium is an essential mineral required for bone formation and maintenance, nerve transmission, muscle contraction, and many cellular functions. Vitamin D3 (Cholecalciferol) facilitates the absorption of calcium from the gastrointestinal tract and helps in its utilization by the body.
Pharmacokinetics
Onset
The therapeutic effects on bone density and calcium levels are gradual and typically observed over weeks to months of consistent use.
Excretion
Calcium is primarily excreted via urine and feces. Vitamin D3 and its metabolites are mainly excreted in bile and feces, with some renal excretion.
Half life
Elemental calcium has complex pharmacokinetics with varying half-lives depending on compartments. Vitamin D3 (Cholecalciferol) has a plasma half-life of approximately 24 hours, but its active metabolites have longer durations.
Absorption
Calcium absorption from the gut is variable and depends on factors like Vitamin D status, age, and dietary intake. Vitamin D3 is well absorbed from the small intestine.
Metabolism
Calcium is not metabolized in the traditional sense; it is absorbed and incorporated into bone or excreted. Vitamin D3 is hydroxylated in the liver to 25-hydroxyvitamin D [25(OH)D] and then in the kidneys to the active form, 1,25-dihydroxyvitamin D [1,25(OH)2D] (calcitriol).
Side Effects
Contraindications
- Hypercalcemia (abnormally high levels of calcium in the blood).
- Hypercalciuria (abnormally high levels of calcium in the urine).
- Severe renal impairment or kidney stones (nephrolithiasis/nephrocalcinosis).
- Hypersensitivity to Calcium Carbonate, Cholecalciferol, or any other component of the formulation.
- Primary hyperparathyroidism or other conditions leading to hypercalcemia.
Drug Interactions
Levothyroxine
Calcium can impair the absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can interfere with the absorption of bisphosphonates. Administer calcium at least 30 minutes after or later in the day.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion, requiring higher calcium/Vitamin D doses.
Thiazide diuretics
May reduce calcium excretion, increasing the risk of hypercalcemia.
Tetracycline and Fluoroquinolone antibiotics
Calcium can chelate these antibiotics, reducing their absorption. Administer at least 2-3 hours before or 4-6 hours after the antibiotic.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, polydipsia, polyuria, anorexia, and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing the supplement, ensuring adequate fluid intake, and in severe cases, intravenous fluids and diuretics. Calcium levels should be monitored.
Pregnancy & Lactation
This medicine is generally considered safe during pregnancy and lactation when taken at recommended doses. Calcium and Vitamin D are essential for fetal bone development and are secreted in breast milk. However, it should only be used under medical supervision, and excessive doses should be avoided due to potential risks of hypercalcemia.
Side Effects
Contraindications
- Hypercalcemia (abnormally high levels of calcium in the blood).
- Hypercalciuria (abnormally high levels of calcium in the urine).
- Severe renal impairment or kidney stones (nephrolithiasis/nephrocalcinosis).
- Hypersensitivity to Calcium Carbonate, Cholecalciferol, or any other component of the formulation.
- Primary hyperparathyroidism or other conditions leading to hypercalcemia.
Drug Interactions
Levothyroxine
Calcium can impair the absorption of levothyroxine. Separate administration by at least 4 hours.
Bisphosphonates
Calcium can interfere with the absorption of bisphosphonates. Administer calcium at least 30 minutes after or later in the day.
Corticosteroids
Can reduce calcium absorption and increase calcium excretion, requiring higher calcium/Vitamin D doses.
Thiazide diuretics
May reduce calcium excretion, increasing the risk of hypercalcemia.
Tetracycline and Fluoroquinolone antibiotics
Calcium can chelate these antibiotics, reducing their absorption. Administer at least 2-3 hours before or 4-6 hours after the antibiotic.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose (hypercalcemia) may include nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, polydipsia, polyuria, anorexia, and in severe cases, cardiac arrhythmias and coma. Management involves discontinuing the supplement, ensuring adequate fluid intake, and in severe cases, intravenous fluids and diuretics. Calcium levels should be monitored.
Pregnancy & Lactation
This medicine is generally considered safe during pregnancy and lactation when taken at recommended doses. Calcium and Vitamin D are essential for fetal bone development and are secreted in breast milk. However, it should only be used under medical supervision, and excessive doses should be avoided due to potential risks of hypercalcemia.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture, specific to the product.
Availability
Pharmacies and drugstores
Approval Status
Approved by regulatory authorities (e.g., DGDA)
Patent Status
Generic
Clinical Trials
Extensive clinical research supports the efficacy and safety of calcium and Vitamin D supplementation for bone health, osteoporosis prevention, and treatment of deficiencies.
Lab Monitoring
- Serum calcium levels (especially in patients with renal impairment or those on prolonged high-dose therapy).
- Serum 25(OH)D levels (Vitamin D status).
- Renal function tests (e.g., creatinine) in patients with kidney issues.
- Urine calcium excretion (in cases of hypercalciuria risk).
Doctor Notes
- Advise patients on appropriate dietary calcium and Vitamin D intake.
- Monitor serum calcium and renal function in patients with pre-existing renal impairment or those at risk of hypercalcemia.
- Emphasize the importance of adherence to prescribed dosage and separation from interacting medications.
Patient Guidelines
- Take the tablet exactly as prescribed by your doctor or as indicated on the package.
- Do not exceed the recommended daily dose.
- Inform your doctor or pharmacist about all other medications and supplements you are taking to avoid potential interactions.
- Store the medicine in a cool, dry place, away from direct sunlight and moisture.
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
Xtracal-D is not known to affect the ability to drive or operate machinery. If you experience any side effects that impair your concentration, avoid these activities.
Lifestyle Advice
- Maintain a balanced diet rich in calcium (e.g., dairy products, leafy green vegetables) and Vitamin D (e.g., fatty fish, fortified foods).
- Ensure adequate sun exposure to naturally boost Vitamin D synthesis, while taking precautions against sunburn.
- Engage in regular weight-bearing exercises to support bone density.
- Limit alcohol consumption and avoid smoking, as these can negatively impact bone health.
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