Calcium Sandoz Forte - extra strength will not hurt your joints and bones. Calcium Sandoz Forte For renal impairment

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 faint odor (10 or 20 pieces in polypropylene cases, in a cardboard box 1 case and instructions for use 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);
• Excipients: sodium bicarbonate – 250/500 mg, citric 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 is easy to digest and allows you to ensure adequate calcium intake in the form of a tasty drink.

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

Pharmacokinetics

About 25–50% of an ingested dose of calcium is absorbed mainly in the proximal 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 an additional remedy for 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 the standard dosage regimen.

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, the development of systemic allergic reactions, manifested as anaphylactic reactions, facial swelling, and angioedema, is possible. 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, hydration using a 0.9% sodium chloride solution is prescribed at the initial stage. 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 must be excluded, including 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 renal impairment, as well as 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 form stones in the urinary tract are advised to increase their 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 there are special indications for this.

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.

In cases of mild or moderate impairment of renal function, as well as in cases of aggravated history of urolithiasis, regular monitoring of urinary calcium excretion is necessary. If necessary, reduce the dose of Calcium Sandoz Forte or discontinue the drug completely.

Drug interactions

When using Calcium Sandoz Forte simultaneously with certain medications, 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: decrease in urinary calcium excretion (regular monitoring of serum calcium concentration is necessary due to the existing risk 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: reducing their absorption from the gastrointestinal tract (the interval between taking Calcium Sandoz Forte and the above drugs should be at least 3 hours).

Calcium absorption from the gastrointestinal tract may be reduced when taken simultaneously 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 (a break of at least 2 hours between taking the drug and food rich in phytic or oxalic acid).

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.

Calcium Sandoz Forte is a medicine that contains calcium.

Active ingredient

Calcium carbonate + Calcium lactogluconate.

Release form and composition

Available in the form of effervescent tablets with a pleasant orange aroma and taste.

Indications for use

• bone demineralization in older women;
• osteoporosis;
• rickets;
• osteomalacia;
• tetany;
• increased need for calcium during child growth, pregnancy and lactation;
• allergic reactions.

Contraindications

• hypercalciuria;
• insufficient kidney function;
• hypercalcemia (including with an overdose of vitamin D, as well as with decalcifying tumors, bone metastases, hyperparathyroidism)
• hypersensitivity to the components of the drug.

Instructions for use Calcium Sandoz Forte (method and dosage)

Take 500-1000 mg per day, which is equal to one or two tablets. The tablet must be dissolved in a glass of water and drunk. In difficult situations with severe calcium deficiency, at the beginning of treatment it is recommended to take 2000 mg per day, which is equal to four tablets.

Side effects

Very rarely, Calcium Sandoz Forte can cause side effects such as diarrhea, flatulence or constipation.

Overdose

An overdose of Calcium Sandoz Forte can lead to the development of hypercalciuria and hypercalcemia.

Symptoms of hypercalcemia: nausea, vomiting, thirst, polydipsia, polyuria, dehydration and constipation. Chronic overdose provokes liming of blood vessels and organs.

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

• If signs of hypercalcemia are detected, hydration with 0.9% sodium chloride solution is carried out at the initial stage.
• To enhance the excretion of calcium, as well as to avoid the formation of edema in the tissues, loop diuretics are 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 A or D, primary hyperparathyroidism, malignant tumors, renal failure, stiffness of movement.

Analogues

Calcium gluconate, Calcium Glycerophosphate.

Pharmacological action

The preparation contains calcium - one of the essential elements that affects all systems of our body and without which any processes in it are impossible. It is not only the basis for the formation of the skeleton, but is necessary for the normalization of heart function, the process of blood clotting, and also for ensuring the transmission of nerve impulses.

This is a medicinal product intended for internal use. It contains ionized calcium salts, which help to easily compensate for the deficiency of the element in the body. They also make it possible to normalize the balance of electrolytes. The product contains a larger amount of active substance and has a prolonged effect.

Special instructions

• In patients with mild hypercalciuria (exceeding 300 mg/day or 7.5 mmol/day), with mild or moderate renal dysfunction, as well as in the presence of anamnestic indications of urolithiasis, regular monitoring of urinary calcium excretion is required.
• If necessary, the dose of the drug is reduced or it is discontinued altogether. Patients with a tendency to form stones in the urinary tract are advised to increase their fluid intake.
• In patients with impaired renal function, calcium salts should be taken under medical supervision with constant monitoring of serum calcium and phosphate levels.
• When treating with calcium preparations, it is necessary to avoid taking large doses of vitamin D or its derivatives, unless there are special indications for this.
• One effervescent tablet contains 0.002 XE, so the drug can be used in patients with diabetes.
• Does not affect the ability to drive a car or operate machinery.

During pregnancy and breastfeeding

Used during pregnancy and breastfeeding.

In childhood

Contraindicated in children under 3 years of age.

In old age

No information available.

Drug interactions

• The drug in large doses can significantly reduce the effect of Verapamil. It also increases the risk of arrhythmia when combined with digitalis.
• Enhances the absorption of aluminum, and significantly reduces the absorption of phenytoin, quinolones, estramustine, etidronate, as well as tetracyclines and drugs containing fluoride.
• Taken in combination with vitamin D improves calcium absorption.
• When taken in combination with tetracycline antibiotics, the absorption of the latter may be reduced. If joint treatment is necessary, tetracycline drugs should be taken 6 hours after taking calcium or 2 hours before taking calcium.
• Diuretics reduce the excretion of calcium in the urine, so it is recommended to regularly monitor the concentration of the mineral in the blood serum to avoid the development of hypercalcemia.