Calcium Sandoz Forte - extra strength will not hurt your joints and bones. Calcium-Sandoz ® forte Calcium carbonate 1000 mg daily how to take

Calcium Sandoz Forte: instructions for use and reviews

Latin name: Calcium Sandoz forte

ATX code: A12AA20

Active substance: calcium carbonate (calcium carbonate) + calcium lactogluconate (calcium lactogluconate)

Manufacturer: Famar Orleans (France)

Updating the description and photo: 09.09.2019

Calcium Sandoz Forte is a drug used to replenish calcium deficiency.

Release form and composition

The drug is produced in the form of effervescent tablets: round, flat, with a beveled edge and a slightly rough surface, from almost white to white, with a specific weak odor (10 or 20 pieces in polypropylene cases, 1 case in a cardboard box and instructions for use of Calcium Sandoz Forte).

1 tablet contains (respectively):

• Active substance: ionized calcium – 500/1000 mg or 12.5/25 mmol (in the form of calcium carbonate – 875/1750 mg and calcium lactogluconate – 1132/2263 mg);
• Auxiliary components: sodium bicarbonate – 250/500 mg, lemon acid– 1662/3323 mg, aspartame – 30/30 mg, macrogol 6000 – 125/250 mg, orange flavor – 30/30 mg (orange flavor contains butylated hydroxyanisole (E320), sulfur dioxide (E220), sorbitol).

Pharmacological properties

Pharmacodynamics

Calcium Sandoz Forte is a calcium preparation for oral administration.

Calcium is a vital mineral element; it is required to maintain the balance of electrolytes in the body and the adequate functioning of various regulatory mechanisms. Helps replenish Ca 2+ deficiency, takes part in phosphate-calcium metabolism, has antirachitic, vitamin, antiallergic and anti-inflammatory effects.

The drug contains two calcium salts (lactogluconate and calcium carbonate), which, quickly dissolving in water, are converted into the active ionized form of calcium. This dosage form characterized by easy absorption and allows for adequate intake of calcium in the body in the form delicious drink.

The drug is intended for the treatment and prevention of acute/chronic calcium deficiency in the body, as well as for therapy different types metabolic disorders in bone tissue.

Pharmacokinetics

About 25–50% of an ingested dose of calcium is absorbed primarily in proximal part small intestine, after which it enters the metabolic calcium depots.

In the body, 99% of calcium reserves are contained in teeth and bones, 1% is part of intra- and extracellular fluids. Approximately 50% of the total calcium content in the blood is present in physiologically active ionized form, about 5% forms complexes with phosphate, citrate and other anions. The rest of the calcium is bound to proteins (mainly albumin) in the blood serum.

Excretion is carried out by the kidneys and through the intestines (20% and 80%, respectively). The level of excretion through the kidneys is determined by glomerular filtration and tubular reabsorption. The intestines excrete both unabsorbed calcium and the absorbed part that is excreted in pancreatic secretions and bile.

Indications for use

• Calcium deficiency, including that occurring during pregnancy, lactation and rapid growth in children (treatment and prevention);
• Osteoporosis (as additional means To specific therapy and prevention);
• Allergic reactions (supportive treatment);
• Osteomalacia (as an addition to basic therapy, including vitamin D3).

Contraindications

• Hypercalciuria;
• Hypercalcemia;
• Chronic renal failure;
• Phenylketonuria;
• Nephrocalcinosis and nephrourolithiasis;
• Fructose intolerance, isomaltase/sucrase deficiency, glucose-galactose malabsorption;
• Hypersensitivity to the components of the drug.

Calcium Sandoz Forte, instructions for use: method and dosage

The drug is taken orally, regardless of food intake. The tablet should be dissolved in 200 ml (1 glass) of water before use.

The dosage regimen is determined by age:

• Adults and children over 10 years old: Calcium Sandoz forte 1000 mg 1 time per day;
• Children 3-9 years old: Calcium Sandoz forte 500 mg 1 time per day.

With an increased need for calcium or in severe cases (for example, during treatment with bisphosphonates), the daily dose may be increased to 2000 mg.

In the treatment and prevention of osteoporosis in adults and children, Calcium Sandoz Forte is prescribed according to standard scheme taking the drug.

To compensate for calcium deficiency, the duration of therapy is usually at least 4-6 weeks. The duration of taking the drug as part of the complex treatment of osteoporosis is determined by the doctor individually.

The daily dose of calcium during pregnancy should not exceed 1500 mg (hypercalcemia can lead to disturbances in fetal development).

Side effects

While taking Calcium Sandoz Forte, it is possible to develop side effects that occur with varying frequency:

• Very rare (less than 1/10,000 cases): hypersensitivity reactions, including rash, urticaria, itching, hypercalcemia. In isolated cases, it is possible to develop systemic allergic reactions, manifested as anaphylactic reactions, facial swelling, angioedema. There are also reports of hypercalciuria with calcium supplementation;
• Rarely (more than 1/10,000 and less than 1/1000 cases): constipation, epigastric pain, flatulence, diarrhea, vomiting, nausea.

When taking high doses of Calcium Sandoz Forte (daily 2000 mg per day for several months), headaches, increased fatigue, polyuria and thirst may develop.

Overdose

An overdose of Calcium Sandoz forte leads to the development of hypercalcemia and hypercalciuria.

The main symptoms of hypercalcemia: vomiting, nausea, thirst, polyuria, polydipsia, constipation, dehydration. In case of chronic overdose in case of development of hypercalcemia, liming of blood vessels and organs is possible. The threshold for calcium intoxication is determined by taking calcium supplements for several months at a daily dose above 2000 mg.

In case of intoxication, you must immediately stop taking Calcium Sandoz Forte and restore the water and electrolyte balance.

In case of chronic overdose, if symptoms of hypercalcemia are detected on initial stage Hydration is prescribed using a 0.9% sodium chloride solution. In order to enhance the excretion of calcium, as well as to reduce the likelihood of the formation of edema in the tissues (in particular, in congestive heart failure), loop diuretics, for example, furosemide, can be used. The use of thiazide diuretics should be avoided.

In patients with renal failure, hydration is ineffective; such patients are prescribed dialysis. In the case of persistent hypercalcemia, other factors that contribute to its occurrence should be excluded, incl. malignant tumors, hypervitaminosis of vitamin A or D, primary hyperparathyroidism, stiffness of movement, renal failure.

special instructions

In patients with mild hypercalciuria (above 300 mg or 7.5 mmol per day), moderate or mild functional renal impairment, as well as in the presence of a history of urolithiasis urinary calcium excretion should be regularly monitored. If necessary, reduce the dose of Calcium Sandoz Forte or discontinue it. Patients with a tendency to develop urinary tract stones, it is recommended to increase fluid intake.

In case of functional impairment of the kidneys, the intake of calcium salts should be carried out under medical supervision (monitoring of the levels of phosphate and calcium in the blood serum is necessary).

When using the drug, you should avoid taking high doses of vitamin D or its derivatives, unless indicated for this purpose. special indications.

Patients on a salt-restricted diet should take into account the sodium content of the effervescent tablets: 68.45 mg (2.976 mmol) sodium per 1 tablet Calcium Sandoz forte 500 mg and 136.90 mg (5.95 mmol) sodium per tablet Calcium Sandoz forte 1000 mg.

1 effervescent tablet contains 0.002 XE (bread units), so the drug can be used by patients with diabetes.

Use during pregnancy and lactation

When taking the drug during pregnancy, the dose of calcium should not exceed 1500 mg/day. If hypercalcemia occurs during pregnancy, disturbances in fetal development may occur.

Use in childhood

The drug is not prescribed to patients under 3 years of age.

For impaired renal function

In severe renal failure, the use of Calcium Sandoz Forte is contraindicated.

For mild or moderate impairments renal function, as well as with a complicated history of urolithiasis, regular monitoring of urinary calcium excretion is necessary. If necessary, the dose of Calcium Sandoz Forte is reduced or the drug is discontinued completely.

Drug interactions

When using Calcium Sandoz Forte simultaneously with certain medicines Undesirable effects may occur:

• Estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations: reducing their absorption (the interval between taking Calcium Sandoz Forte and the above drugs should be at least 3 hours);
• Vitamin D and its derivatives: increased calcium absorption;
• Vitamin D and its derivatives simultaneously with high doses of Calcium Sandoz Forte: reducing the effect of verapamil and possibly other calcium channel blockers;
• Tetracycline drugs: impaired absorption (tetracycline drugs should be used at least 2 hours before or 4-6 hours after taking Calcium Sandoz Forte);
• Thiazide diuretics: decreased urinary calcium excretion (regular monitoring of serum calcium concentrations is necessary due to existing risk development of hypercalcemia);
• Systemic corticosteroids: decreased calcium absorption (an increase in the dose of Calcium Sandoz Forte may be required);
• Cardiac glycosides: increase in their toxicity due to the development of hypercalcemia (it is necessary to regularly monitor the level of calcium in the blood serum and take an ECG);
• Bisphosphonate or sodium fluoride: decreased absorption from gastrointestinal tract(the interval between taking Calcium Sandoz Forte and the above drugs should be observed for at least 3 hours).

Absorption of calcium from the gastrointestinal tract may be reduced by simultaneous administration with certain types of food containing oxalic acid (for example, spinach, rhubarb) or phytic acid (all grains), which is associated with the formation of insoluble complexes with calcium ions (it is necessary to maintain a break of at least 2 hours between taking the drug and food rich in phytic or oxalic acid acids).

Analogues

Analogues of Calcium Sandoz Forte are: Calviv, Vitrum-calcium, Calcium-D3-Nycomed.

Terms and conditions of storage

Store out of reach of children in a tightly closed container at temperatures up to 30 °C.

Shelf life – 3 years.

1 calcium tablet lactogluconate 1132 mg or 2263 mg, calcium carbonate 875 mg or 1750 mg.

Citric acid, butyl hydroxyanisole, macrogol 6000, , sodium bicarbonate, flavoring, as excipients.

Release form

Soluble tablets 500 mg and 1000 mg.

pharmachologic effect

Replenishment of calcium deficiency.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Calcium is an important element that is necessary for the regulation of many processes in the body, maintaining electrolyte balance and participation in calcium phosphate metabolism. This drug replenishes its deficiency when various states, and is prescribed for metabolic disorders in bone tissue. Renders antirachitic And antiallergic action.

The drug contains two calcium salts, which in the form of effervescent tablets quickly dissolve, turning into active form. This dosage form ensures easy absorption and entry of calcium into the body.

Pharmacokinetics

About 25–50% of ionized calcium is absorbed in the small intestine and enters calcium stores. Largest quantity it (99%) is found in bones and teeth, 1% is found in extracellular fluid. About 50% of total calcium in the blood is present in active ionized form, 5% in the form of anionic complexes, and 45% is bound to proteins. Approximately 20% is excreted by the kidneys in urine and 80% in feces. The degree of excretion by the kidneys depends on glomerular filtration.

Indications for use

• in postmenopause;
• drug-induced osteoporosis;
• insufficiency in the diet;
• osteomalacia (in combination with vitamin D3);
• allergic reactions;
• increased need (during pregnancy, breastfeeding, period of intensive growth);
• latent course tetany .

Contraindications

• chronic;
• hypercalcemia , hypercalciuria ;
• hypersensitivity to the drug;
• , nephrocalcinosis ;
• , fructose intolerance;
• age up to 3 years.

Side effects

Very rarely, Calcium Sandoz Forte can cause:

• rash, facial swelling, itching, urticaria, ;
• hypercalcemia , hypercalciuria ;
• , vomiting, nausea, epigastric pain.

When taking 2000 mg per day for several months, headache, thirst, fatigue, polyuria .

Instructions for use (Method and dosage)

The tablet is dissolved in water and taken orally regardless of meal time. Adults are prescribed 1000 mg/day. If the need is increased, the dose is increased to 2000 mg/day. Children from 3 years of age: 500 mg/day, and from 10 years of age, an adult dose is prescribed.

The duration of treatment is 4–6 weeks. For prevention and treatment osteoporosis The duration of treatment is determined individually.

At pregnancy daily dose no more than 1500 mg. In patients with impaired renal function and in the presence urolithiasis Constant monitoring of calcium in urine is necessary.

Overdose

Overdose of Calcium Sandoz Forte manifests itself with symptoms hypercalcemia : nausea, vomiting, polyuria , thirst, polydipsia , dehydration , constipation. When taking more than 2000 mg/day for several months, chronic overdose occurs, which can lead to liming of blood vessels .

Treatment: restoration of water and electrolyte balance - carried out hydration .In order to enhance the excretion of the drug, they are used loop diuretics (), thiazide diuretics are not assigned. Patients with renal failure shown dialysis .

Interaction

Due to the formation of non-absorbable complexes, the drug may reduce the absorption of the cytostatic estramustine ,bisphosphonate etidronate , drugs fluoride , tetracyclines , quinolones . Therefore, the interval between taking these drugs and effervescent tablets should be 3 hours or more.

Co-administration with vitamin D increases the absorption of calcium, which reduces the effect.

Thiazide diuretics reduce the excretion of the drug in the urine, and there is a risk of developing hypercalcemia, and therefore, when prescribing these diuretics simultaneously, it is necessary to monitor the calcium level in the blood.

Corticosteroids reduce its absorption, so it may be necessary to increase the dose.

Due to the development of hypercalcemia when taken simultaneously cardiac glycosides their toxicity increases. ECG should be monitored regularly.

Absorption of the drug from the gastrointestinal tract is reduced when consuming spinach, rhubarb (oxalic acid) or grains containing phytic acid, since insoluble complexes are formed. In this case, effervescent tablets must be taken 2 hours before eating this food.

Terms of sale

Over the counter.

Storage conditions

At a temperature not exceeding 30°C.

Best before date

Analogues

Level 4 ATX code matches:

, , CalViv .

Reviews of Calcium Sandoz Forte

Let us recall that daily norm calcium increases with age and amounts to 1000-1500 mg/day, and the source of its intake does not matter - food or medications. If the diet contains 1000 mg, then only 200-300 mg is included in metabolism. Dairy products contain the most of this element, and it is absorbed almost completely. In green vegetables and cereals, it is found in the form of insoluble salts (oxalates and phosphates), the absorption of which is significantly lower.

The drug is prescribed in cases where there is an increased need for calcium (pregnancy, enhanced growth child), with diabetic osteoarthropathy , rickets , allergic dermatitis .

To improve the healing of fractures and prevent osteoporosis, Calcium Sandoz Forte is also prescribed. Reviews from doctors indicate the effectiveness of this drug in various pathologies bone tissue. Employees of the Department of Traumatology and Orthopedics of the Belarusian State Medical University in Ufa published the results of the use of this drug in complex treatment(With vitamin D And bisphosphonates ) juvenile osteoporosis in children. It is noted that the drug contains rapidly soluble ionized salts ( lactogluconate And carbonate ), which have high bioavailability, that is, they are well absorbed, which cannot be said about calcium gluconate . However, it reduces acidity gastric juice. Calcium Sandoz Forte is approved for use in children from 3 years of age, which expands the possibilities of its use. For example, And Calcemin Advance can only be used in children over 12 years of age. It is better to take the drug in the evening, since at this time maximum absorption is observed (after 19 hours).

At the Department of Gynecology of Minsk medical institute, developing methods for correcting osteoporosis, have once again proven that the role of calcium metabolism disorders in the occurrence of osteoporosis is undeniable, but its preparations and vitamin D are not the basis for treatment. The basis for the prevention and treatment of osteoporosis is substitution hormone therapy (estrogens And gestagens in various combinations). And calcium supplements, bisphosphonates, vitamin D, calcitonin and fluorides are used in the complex treatment of this disease. It should be taken into account that drugs containing well-absorbed salts will be effective for this disease.

Analyzing reviews of Calcium Sandoz Forte, we can draw a conclusion about the effectiveness of the drug. Users note its availability in pharmacy chain, convenient release form - instant tablets soluble in water.

“I couldn’t swallow tablets from other manufacturers because of their large size. And these are a pleasure"

“I believe that I saved my teeth during pregnancy and breastfeeding only thanks to these tablets. Reviews are only positive"

“My hair began to fall out a lot and my nails began to break. I took 20 tablets and felt improvements in my hair and nails.”

According to reviews, the drug is well tolerated; only some people noted pain in the stomach and constipation with long-term use.

Price Calcium Sandoz Forte, where to buy

You can buy it in many pharmacies in Moscow and other cities. The price of Calcium Sandoz Forte 500 mg No. 10 ranges from 163 rubles. up to 244 rub. The cost of tablets 1000 mg No. 10 is from 320 rubles. up to 404 rub.

Calcium Sandoz Forte is a mineral supplement that replenishes calcium deficiency in the body.

Release form and composition

Calcium Sandoz Forte is available in the form of effervescent tablets, 10 and 20 pcs. in polypropylene cases, one case in a cardboard box.

Active ingredients of the drug:

• Calcium lactogluconate – 1132 mg or 2263 mg per tablet;
• Calcium carbonate – 875 mg or 1750 mg per tablet.

* which corresponds to the content of 500 mg or 1000 mg Ca 2+ in one tablet, respectively.

Auxiliary components: citric acid, macrogol 6000, aspartame, sodium bicarbonate and orange flavor containing sorbitol, butylated hydroxyanisole (E320) and sulfur dioxide (E220).

Indications for use

• Treatment and prevention of calcium deficiency, including in children during the period of intensive growth, in pregnant and breastfeeding women;
• Osteomalacia (as an auxiliary drug);
• Prevention and treatment of osteoporosis (in addition to specific therapy);
• Allergic reactions (as maintenance therapy).

Contraindications

• Hypercalciuria;
• Hypercalcemia;
• Nephrocalcinosis;
• Nephrourolithiasis;
• Chronic renal failure;
• Glucose-galactose malabsorption, sucrase/isomaltase deficiency and fructose intolerance;
• Phenylketonuria;
• Children under 3 years of age;
• Increased sensitivity to the components of the drug.

Directions for use and dosage

The tablets are taken orally, dissolved immediately before use in a glass of water, at any convenient time - regardless of meals.

Children 3-9 years old are prescribed 500 mg per day, children over 10 years old and adults – 1000 mg per day. In severe cases and with an increased need for calcium (for example, during treatment with bisphosphonates), the daily dose can be increased to 2000 mg.

The duration of use of Calcium Sandoz Forte is determined individually in each case. When taken to compensate for calcium deficiency, the course of treatment is at least 4-6 weeks.

Side effects

In general, the drug is well tolerated. In rare cases, the following are noted:

• Hypersensitivity reactions, incl. hypercalcemia, itching, rash, urticaria;
• Systemic allergic reactions - facial swelling, angioedema, anaphylactic reactions;
• Nausea, vomiting, flatulence, epigastric pain, constipation or diarrhea.

With long-term use of Calcium Sandoz Forte in high doses (2000 mg per day), headache, polyuria, and increased fatigue are possible.

An overdose of calcium leads to the development of hypercalciuria and hypercalcemia, manifested by thirst, nausea, vomiting, polyuria, polydipsia, dehydration and constipation. Chronic overdose with hypercalcemia can lead to liming of organs and blood vessels. Intoxication threshold – long-term use(for several months) more than 2000 mg of calcium per day.

At the initial stage of chronic overdose, the body is hydrated using a 0.9% sodium chloride solution. In some cases, loop diuretics are used - they help enhance the excretion of calcium and prevent the formation of edema in the tissues. In case of intoxication, it is necessary to restore the water and electrolyte balance.

In case of persistent hypercalcemia, additional examination is prescribed to exclude other factors contributing to its development, including hypervitaminosis D and A, renal failure, primary hyperparathyroidism, stiffness of movement, malignant tumors.

In patients with kidney failure, hydration is ineffective, so they are given dialysis.

special instructions

When taking Calcium Sandoz Forte during pregnancy, in order to prevent the development of hypercalcemia, which can cause disturbances in the fetus, the dose should not exceed 1500 mg per day.

For patients with mild to moderate pronounced violations renal function, with slight hypercalciuria (exceeding 7.5 mmol/day), as well as in the presence of a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose or discontinue the drug. In case of impaired renal function, the level of calcium and phosphate in the blood serum should also be monitored.

Patients with a tendency to form stones in the urinary tract during treatment should consume a large number of liquids.

Unless there are special indications for this, you should not take vitamin D and its derivatives in high doses while taking Calcium Sandoz Forte.

People following a diet with limited salt intake should take into account that 1 500 mg tablet contains 2.976 mmol of sodium, 1 1000 mg tablet contains 5.95 mmol (equivalent to 68.45 and 136.90 mg of sodium, respectively).

1 tablet of Calcium Sandoz Forte contains 0.002 XE, so the drug can be taken by patients with diabetes.

The mineral supplement does not have a negative effect on the ability to concentrate and visual acuity.

The absorption of calcium from the gastrointestinal tract is reduced by foods containing oxalic acid (for example, rhubarb and spinach) and phytic acid (cereals). For this reason, you should not take calcium 2 hours before or 2 hours after eating such a meal.

Drug interactions

Calcium Sandoz Forte may reduce the absorption of etidronate, estramustine and possibly other bisphosphonates, fluoride preparations, quinolones and phenytoin. Therefore, at least 3-hour intervals should be observed between taking these medications.

Calcium absorption is enhanced by vitamin D and its derivatives.

The combination of Calcium Sandoz Forte in high doses and vitamin D, when used simultaneously, reduces the effect of verapamil and, possibly, other calcium channel blockers.

When used in combination, the absorption of tetracycline antibiotics is impaired, so it is recommended to take them 2 hours before or 4-6 hours after taking a calcium supplement.

An increased dose of Calcium Sandoz Forte may be required when systemic corticosteroids are co-administered as they reduce calcium absorption.

Urinary calcium excretion is reduced when taking thiazide diuretics, which increases the risk of developing hypercalcemia. During treatment, it is necessary to regularly monitor the concentration of calcium in the blood serum.

Calcium Sandoz Forte may increase the toxicity of cardiac glycosides. Patients receiving these drugs require ECG monitoring and monitoring of blood calcium levels.

Terms and conditions of storage

Store in a tightly closed container in a place where the temperature does not exceed 30 ºC.

Shelf life – 3 years.

Found an error in the text? Select it and press Ctrl + Enter.

Prevention and treatment of calcium deficiency; prevention and treatment of osteoporosis (in complex therapy); treatment of rickets and osteomalacia (in complex therapy with vitamin D3).

Pharmacotherapeutic group

Calcium-phosphorus metabolism regulator.

Pharmacological property

Calcium is a vital mineral element necessary to maintain the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects. Calcium Sandoz Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment various types metabolic disorders in bone tissue.

Contraindications

Hypersensitivity to the components of the drug, increased concentration of calcium in the blood and urine (hypercalcemia, hypercalciuria), chronic renal failure, nephrourolithiasis, nephrocalcinosis, phenylketonuria and sucrose/isomaltose deficiency, fructose intolerance, glucose-galactose malabsorption. Calcium Sandoz Forte is not recommended for use in children under 3 years of age due to the lack of data on effectiveness and safety in this category.

Application

Inside, regardless of food intake. Before taking, the tablet is dissolved in a glass of water. Children from 3 to 9 years old: 500 mg per day. Adults and children over 10 years old: 1000 mg per day. In severe cases or with an increased need for calcium (for example, when treating with bisphosphonates), the dose may be increased to 2000 mg per day. Duration of therapy : when used for the prevention and treatment of calcium deficiency, the average duration of treatment is at least 4 - 6 weeks; when used for the prevention and treatment of osteoporosis, treatment of rickets and osteomalacia, the duration of treatment is determined individually.

Side effects

Immune system disorders: rarely: hypersensitivity reactions, incl. rash, itching, urticaria; very rare: systemic allergic reactions (such as anaphylactic reactions, facial edema, angioedema) have been reported in isolated cases. Metabolic and nutritional disorders: uncommon: hypercalcemia, hypercalciuria. Gastrointestinal disorders: rarely: flatulence, constipation, diarrhea, nausea, vomiting, abdominal pain. When taken in high doses (2000 mg/day when taken daily for several months), headache, fatigue, thirst, and polyuria may occur.

Overdose

Overdose leads to the development of hypercalciuria and hypercalcemia. Symptoms of hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation. Chronic overdose with the development of hypercalcemia can lead to liming of blood vessels and organs. The threshold for calcium intoxication is when taking calcium supplements for several months at a dose exceeding 2000 mg/day. Therapy in case of overdose In case of intoxication, therapy should be stopped immediately and the water and electrolyte balance should be restored. In case of chronic overdose, if signs of hypercalcemia are detected at the initial stage, hydration is carried out using a 0.9% sodium chloride solution. To enhance the excretion of calcium, as well as to avoid the formation of edema in the tissues (for example, in congestive heart failure), loop diuretics, for example, furosemide, can be used. In this case, you should refrain from using thiazide diuretics. In patients with renal failure, hydration is ineffective; dialysis is indicated for such patients. In the case of persistent hypercalcemia, other factors contributing to its development should be excluded, including hypervitaminosis of vitamin A or D, primary hyperparathyroidism, malignant tumors, renal failure, and stiffness.

Interaction with other drugs

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours. Simultaneous administration of vitamin D and its derivatives increases calcium absorption. When prescribed in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other calcium channel blockers. With the simultaneous use of effervescent calcium carbonate + calcium lactogluconate tablets and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after ingesting calcium preparations. Thiazide diuretics reduce urinary calcium excretion, so when used concomitantly with effervescent tablets calcium carbonate + calcium lactogluconate & serum calcium concentrations should be regularly monitored, as there is a risk of developing hypercalcemia. Systemic corticosteroids reduce calcium absorption. If they are used simultaneously, it may be necessary to increase the dose of effervescent calcium carbonate + calcium lactogluconate tablets. When ingesting effervescent calcium carbonate + calcium lactogluconate tablets in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum. If a bisphosphonate or sodium fluoride is taken orally, these drugs should be taken at least 3 hours before taking calcium carbonate + calcium lactogluconate effervescent tablets, since absorption from the gastrointestinal tract (GIT) of the bisphosphonate or sodium fluoride may be reduced. Calcium absorption from the gastrointestinal tract may be reduced by concomitant intake of certain foods containing oxalic acid (eg, spinach, rhubarb) or phytic acid (in all grains) due to the formation of insoluble complexes with calcium ions. Patients should not take pills effervescent calcium carbonate + calcium lactogluconate 2 hours before or after a meal rich in oxalic or phytic acid.

Suction

Approximately 25-50% of the dose of calcium taken orally is absorbed mainly in the proximal small intestine and enters the metabolic calcium depots.

Distribution and metabolism

99% of calcium reserves in the body are contained in bones and teeth, 1% is found in intra- and extracellular fluid. Approximately 50% of the total calcium content in the blood is present in the physiologically active ionized form, approximately 5% forms complexes with citrate, phosphate and other anions. The remaining 45% of serum calcium is bound to proteins, mainly albumin.

Removal

About 20% of calcium is excreted through the kidneys and 80% through the intestines. The level of excretion through the kidneys depends on glomerular filtration and tubular reabsorption. Both unabsorbed calcium and the absorbed part of it, which is excreted in bile and pancreatic secretions, are excreted through the intestines.

Overdose

Overdose leads to the development of hypercalciuria and hypercalcemia. Symptoms of hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation.

Chronic overdose with the development of hypercalcemia can lead to liming of blood vessels and organs. The threshold for calcium intoxication is when taking calcium supplements for several months at a dose exceeding 2000 mg/day.

Therapy in case of overdose

In case of intoxication, therapy should be stopped immediately and water and electrolyte balance should be restored.

In case of chronic overdose, if signs of hypercalcemia are detected, hydration is carried out at the initial stage with a 0.9% sodium chloride solution. To enhance the excretion of calcium, as well as to avoid the formation of edema in the tissues (for example, in congestive heart failure), loop diuretics, for example, furosemide, can be used. In this case, you should refrain from using thiazide diuretics.

In patients with renal failure, hydration is ineffective; dialysis is indicated for such patients. In the case of persistent hypercalcemia, other factors contributing to its development should be excluded, incl. hypervitaminosis of vitamin A or D, primary hyperparathyroidism, malignant tumors, renal failure, stiffness of movement.

Storage conditions

The drug should be stored in a tightly closed container at a temperature not exceeding 30°C.

Interaction with other drugs

The combination of calcium carbonate + calcium lactogluconate may reduce the absorption of estramustine, etidronate and possibly other bisphosphonates, phenytoin, quinolones, oral tetracycline antibiotics and fluoride preparations. The interval between taking effervescent calcium carbonate + calcium lactogluconate tablets and the above drugs should be at least 3 hours.

The simultaneous administration of vitamin D and its derivatives increases calcium absorption. When prescribed in high doses along with vitamin D and its derivatives, calcium may reduce the effect of verapamil and possibly other calcium channel blockers.

With the simultaneous use of effervescent tablets calcium carbonate + calcium lactogluconate and tetracycline drugs, the absorption of the latter may be impaired. For this reason, tetracycline preparations should be taken at least 2 hours before or 4-6 hours after ingesting calcium preparations.

Thiazide diuretics reduce urinary calcium excretion, therefore, when used simultaneously with calcium carbonate + calcium lactogluconate effervescent tablets, regular monitoring of serum calcium concentrations should be carried out, as there is a risk of developing hypercalcemia.

Systemic corticosteroids reduce calcium absorption. When used simultaneously, it may be necessary to increase the dose of effervescent calcium carbonate + calcium lactogluconate tablets.

When ingesting effervescent calcium carbonate + calcium lactogluconate tablets in patients receiving cardiac glycosides, the toxicity of cardiac glycosides may increase due to the development of hypercalcemia. Such patients should regularly take an ECG and monitor the level of calcium in the blood serum.

When taking a bisphosphonate or sodium fluoride orally at the same time, these drugs should be taken at least 3 hours before taking effervescent calcium carbonate + calcium lactogluconate tablets, since absorption from the gastrointestinal tract of the bisphosphonate or sodium fluoride may be reduced.

Calcium absorption from the gastrointestinal tract may be reduced by concomitant intake of certain foods containing oxalic acid (for example, spinach, rhubarb) or phytic acid (in all grains), due to the formation of insoluble complexes with calcium ions. Patients should not take calcium carbonate + calcium lactogluconate effervescent tablets 2 hours before or after a meal rich in oxalic or phytic acid.

Side effect

Very rarely (
Rarely (>1/10,000,
When taken in high doses (2000 mg/day when taken daily for several months), headache, fatigue, thirst, and polyuria may occur.

Compound

calcium carbonate 1750 mg

calcium lactogluconate 2263 mg,

Which corresponds to a Ca2+ content of 1000 mg (25 mmol)

Excipients: citric acid - 3323 mg, macrogol 6000 - 250 mg, orange flavor - 30 mg (orange flavor contains sulfur dioxide (E220), butylated hydroxyanisole (E320), sorbitol), aspartame - 30 mg, sodium bicarbonate - 500 mg.

Directions for use and doses

Inside, regardless of food intake. Before taking the tablet, dissolve it in a glass of water.

Children aged 3 to 9 years - 500 mg/day, adults and children over 10 years old - 1000 mg/day.

In severe cases or with an increased need for calcium (for example, during treatment with bisphosphonates), the dose may be increased to 2000 mg/day.

Prevention and treatment of osteoporosis: children aged 3 to 9 years - 500 mg/day, adults and children over 10 years old - 1000 mg/day.

Duration of therapy: when used to replenish calcium deficiency, the average duration of treatment is at least 4-6 weeks. When used for prevention as part of complex therapy for osteoporosis, the duration of treatment is determined individually.

Product description

Effervescent tablets are round, flat, with a beveled edge, from white to almost white in color, with a slight specific odor; tablets have a slightly rough surface.

With caution (Precautions)

In patients with mild or moderately severe renal dysfunction, as well as in the presence of a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it.

special instructions

In patients with mild hypercalciuria (exceeding 300 mg or 7.5 mmol/day), with mild or moderate renal dysfunction, as well as a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or discontinue it. In patients with a tendency to form stones in the urinary tract, increased fluid intake is recommended.

In patients with impaired renal function, calcium salts should be taken under medical supervision. Monitoring of serum calcium and phosphate levels is necessary.

When treating with calcium supplements, it is necessary to avoid taking vitamin D or its derivatives in high doses, unless there are special indications for this.

Patients on a salt-restricted diet should take into account the sodium content of effervescent tablets:

1 effervescent 500 mg tablet contains 2.976 mmol (corresponding to 68.45 mg) sodium;

1 effervescent tablet 1000 mg contains 5.95 mmol (corresponding to 136.90 mg) sodium.

Information for patients with diabetes

1 effervescent tablet contains 0.002 XE, so the drug can be used in patients with diabetes.

Special precautions when disposing of unused drug

There is no need for special precautions when disposing of unused Calcium Sandoz® Forte.

Impact on the ability to drive vehicles and operate machinery

Calcium Sandoz® Forte does not affect the ability to drive a car or operate machinery.

Use during pregnancy and lactation

The drug can be prescribed during pregnancy and breastfeeding on the recommendation of a doctor. Calcium passes into breast milk.

During pregnancy, the daily dose of calcium should not exceed 1500 mg. Hypercalcemia during pregnancy can cause disturbances in fetal development.

Release form

Effervescent tablets are round, flat, with a beveled edge, from white to almost white in color, with a slight specific odor; tablets have a slightly rough surface.
1 tab.
calcium carbonate 1750 mg
calcium lactogluconate 2263 mg,
what soo

Expiration date from date of manufacture

Indications for use

Prevention and treatment of calcium deficiency (including pregnancy, lactation, period of intensive growth in children);

Addition of calcium to specific therapy in the prevention and treatment of osteoporosis;

Allergic reactions (maintenance therapy);

Osteomalacia (as an addition to basic therapy, including vitamin D3).

Contraindications

Hypercalcemia;

Hypercalciuria;

Chronic renal failure;

Nephrourolithiasis;

Nephrocalcinosis;

Phenylketonuria;

Sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;

Hypersensitivity to the components of the drug.

pharmachologic effect

Calcium preparation for oral administration. Calcium is a vital mineral element necessary to maintain the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, antirachitic, anti-inflammatory and antiallergic effects.

Calcium-Sandoz® Forte contains two calcium salts (calcium lactogluconate and calcium carbonate), which in the form of effervescent tablets quickly dissolve in water, turning into an active ionized form of calcium, which is easily absorbed. This dosage form ensures an adequate supply of calcium to the body in the form of a tasty drink and is intended for the prevention and treatment of acute and chronic calcium deficiency in the body, as well as for the treatment of various types of metabolic disorders in bone tissue.