A fixed-dose combination oral liquid supplement containing elemental calcium (as calcium carbonate) and cholecalciferol (Vitamin D3). It is primarily used for the prevention and treatment of calcium and vitamin D deficiencies. In the Indian context, it is widely prescribed for nutritional deficiencies, osteoporosis, and conditions with increased calcium demand such as pregnancy, lactation, and post-menopause.
Adult: Prophylaxis: 5 ml (625mg Calcium + 125 IU D3) once or twice daily. Therapeutic (Deficiency/Osteoporosis): 5 ml twice daily, or as directed by physician. Administer with meals.
Note: Shake the bottle well before use. Use the measuring cup or spoon provided. Take orally, preferably with or immediately after a meal to enhance calcium absorption and reduce gastric discomfort. Do not take with high-fiber meals or foods containing oxalic acid (spinach) or phytic acid (whole grains) as they can bind calcium. Maintain adequate fluid intake.
This combination works synergistically. Calcium provides the essential mineral for bone mineralization, muscle contraction, nerve transmission, and blood coagulation. Vitamin D3 (after activation to calcitriol) enhances intestinal absorption of dietary calcium and phosphate, promotes renal reabsorption of calcium, and regulates bone remodeling by stimulating osteoclast differentiation for bone resorption (to maintain serum calcium) and promoting osteoblast activity for bone formation.
Pregnancy: Category A (US FDA). Calcium and Vitamin D3 requirements increase during pregnancy. Supplementation is recommended in Indian guidelines (ICMR) to prevent maternal bone loss and support fetal skeletal development. Safe in recommended doses. High doses can cause hypercalcemia in mother and fetus.
Driving: No known effects on driving ability.
| Oral Bisphosphonates (Alendronate, Risedronate) | Calcium supplements can significantly reduce absorption of bisphosphonates. Administer at least 2 hours apart. | Major |
| Levothyroxine | Calcium carbonate can decrease levothyroxine absorption. Administer at least 4-6 hours apart. | Major |
| Fluoroquinolone/Tetracycline Antibiotics | Calcium forms insoluble chelates, reducing antibiotic absorption. Administer 2-3 hours before or 4-6 hours after calcium. | Major |
| Digoxin | Hypercalcemia potentiates digoxin toxicity, increasing risk of cardiac arrhythmias. Monitor serum calcium and digoxin levels. | Major |
| Thiazide Diuretics (Hydrochlorothiazide) | Reduce renal calcium excretion, increasing risk of hypercalcemia. Monitor serum calcium. | Moderate |
| Corticosteroids (Prednisolone) | Reduce calcium absorption and increase excretion, potentially negating the supplement's effect. | Moderate |
| Orlistat | May impair absorption of fat-soluble vitamins including Vitamin D3. | Moderate |
| Phenytoin, Phenobarbital, Carbamazepine | Induce hepatic CYP450 enzymes, accelerating metabolism of Vitamin D3 to inactive metabolites, leading to deficiency. | Moderate |
Same composition (Calcium (625mg/5ml) + Vitamin D3 (125iu/5ml)), different brands: