Calcium Sandoz ® Forte (Calcium-Sandoz ® forte). Calcium Sandoz forte - extra strength will not interfere with joints and bones Conditions and shelf life

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Calcium Sandoz forte is a drug that is necessary to increase the level of calcium in the human body.

There are situations when there is a lack of calcium in the body, and this element is necessary for the full growth, strengthening and formation of bone tissue, especially in young children.

In addition, calcium is needed for adults and the elderly to strengthen bones and prevent their fragility. All these functions are filled by Calcium Sandoz.

Release form and composition

Calcium Sandoz forte is available in the form of soluble round tablets in two dosages - 500 mg and 1000 mg.

One tablet contains the following components:

• main components- calcium lactogluconate at a dosage of 1132 mg or 2264 mg, calcium carbonate - 875 mg or 1750 mg;
• additional components- citric acid, butyl hydroxyanisole, macrogol 6000, aspartame, sodium bicarbonate, flavor.

Pharmacological profile

Calcium Sandoz belongs to the group of drugs that normalize the lack of calcium in the body.

Calcium is the main component that is necessary for the human body. It is responsible for the regulation of various important processes in the body, maintains the balance of electrolytes and takes part in the phosphate-calcium metabolism.

Medication Calcium Sandoz compensates for the lack of calcium during. In addition, the tool has anti-rachitic and anti-allergic effects.

This drug in its composition has two calcium salts, which dissolve instantly in the composition of effervescent tablets, as a result of which they become active. Due to the transition to this form, the drug is quickly absorbed and promotes the rapid intake of calcium into the body.

Approximately 25-50% of calcium in an ionized state is absorbed into the walls of the small intestine. The highest level of this component is observed in bone tissue and teeth - almost 99%, the composition of the extracellular fluid includes 1%.

Almost 50% of calcium in the ionized active state is observed in the blood - about 5% in the form of anionic complexes, 45% is associated with proteins. Approximately 20% of the drug is excreted through the kidneys with urine. Almost 80% of the drug is excreted with feces.

Calcium Sandoz-forte is taken for the following conditions and diseases:

Calcium Sandoz is not advisable to take under the following conditions:

• during chronic renal failure;
• in a state of hypercalcemia, hypercalciuria;
• during hypersensitivity to the constituent elements of the drug;
• with urolithiasis;
• with nephrocalcinosis;
• during the state of phenylketonuria;
• if you have fructose intolerance;
• age up to 3 years.

Application scheme

Before taking the medicine, the tablet can be pre-dissolved in water and drink this solution. It can also be drunk internally. while drinking a small amount of water. The medication is taken regardless of the meal.

Dosages:

• children from 3 to 9 years old 500 mg of the drug can be taken per day;
• adults and children over 10 years old up to 1000 mg of the drug should be taken per day;
• in severe cases when an increased level of calcium is needed, the dosage should be increased to 2000 mg per day.

The reception period lasts from 4 to 6 weeks.

The duration of admission with and is determined individually.

How to use during pregnancy and breastfeeding

During pregnancy and lactation, the drug is prescribed by a doctor, so calcium enters the composition of breast milk.

The main thing is that the daily dose of the drug should not exceed 1500 mg. If hypercalcemia occurs, abnormal fetal development may occur.

Cases of overdose

Overdose leads to the appearance of hypercalciuria and hypercalcemia. The following symptoms occur:

• feeling of nausea;
• gagging;
• dryness in the mouth and a feeling of thirst;
• state of polydipsia and polyuria;
• dehydration;
• constipation.

While taking the drug for a long period of time at a dosage of 2000 mg per day, chronic overdose may occur. During it, liming of vessels and organs is observed.

In case of an overdose, therapeutic therapy is carried out, during which the water-electrolyte balance is restored with the help of hydration. To enhance the excretion of the drug, loop diuretics, such as Furasemide, are used. In renal failure, dialysis is performed.

Side effects

Side effects after taking the drug occur quite rarely, sometimes the following symptoms may appear:

• the appearance of a rash, swelling of the facial area, itching, urticaria, angioedema;
• state of hypercalcemia and hypercalciuria;
• sometimes manifested flatulence, constipation, vomiting, diarrhea, nausea, pain in the epigastrium.

While taking the drug at 2000 mg for 24 hours for several months, headaches, severe fatigue, thirst, polyuria may occur.

special instructions

Patients who have a slight hypercalciuria exceeding 300 mg per day, and which is accompanied by mild or moderate renal impairment, as well as the presence of urolithiasis in the indications, need to regularly monitor the level of calcium in the blood.

Also, taking the drug by patients who have problems with the functioning of the kidneys should be carried out under the guidance of a doctor.

It's interesting - practical experience of application

Reviews of doctors and patients who have taken or are taking Calcium Sandoz forte for one purpose or another.

Calcium Sandoz is a drug that helps to replenish the necessary level of calcium in the body. Now is the time that many suffer from a lack of this important element, as a result of this, brittle bones and teeth appear.

This is especially true for children. It is especially important for a child's body to maintain the required level of calcium, because it ensures full growth and development.

But do not take this remedy when there is no need for it. An excess of calcium can lead to unpleasant consequences, firstly, it may be accompanied by overdose symptoms, and secondly, it can cause problems with cardiac activity.

Therapist

Calcium is essential for the development and growth of a growing child's body. But often in children from 3 years old there is a calcium deficiency in the body, as a result, growth retardation, problems in bone development, bone tissue may become fragile and brittle. Needless to say, what unpleasant consequences can all this lead to?

Since this drug can be taken without a prescription, it is not at all difficult to purchase it at a pharmacy. Yes, and the reception of the funds will not cause any special difficulties. Children should be given 500 mg per day. To fully replenish the level of calcium, it is advisable to take the drug from 1.5 to 2 months.

Then you can take a break for 1-2 months and then start taking the remedy again. The main thing during the reception is to observe the dosage, because taking higher doses can lead to overdose symptoms.

Pediatrician

For a long time there was a lack of calcium in the body. As a result of its lack, I had a lot of unpleasant problems - brittle nails, teeth, bones, initial ones. That's all I had to deal with.

I was especially alerted when during the fall I broke my arm, it seems that the blow was not strong, but the bone broke. After the examination, it turned out that I had a low level of calcium in the blood. I was immediately very frightened, but, thank God, the doctor was experienced, he immediately reassured me and recommended drinking Calcium Sandoz.

I immediately bought a package of the drug and started taking it. I took it at 1000 mg per day. The course of admission is 2 months. Surprisingly, my bones have become strong, and my teeth do not break now. This is a real miracle for me!

Svetlana, 29 years old

I was alarmed when my daughter in physical education during the game from hitting the ball with her hand developed severe pain, so severe that she developed a swelling in her wrist. She immediately came home and we went to the hospital.

The x-ray showed that she had a fracture in the bone. I was very surprised, it seems that the blow is not strong, but immediately a crack. Without hesitation, we went to take tests for calcium levels.

As a result, it turned out that she had a lack of calcium, and therefore such fragility of bones. The doctor recommended taking Calcium Sandoz.

I didn’t hesitate, bought this remedy and started giving it to my daughter. She took 1000 mg per day. She took it for 2 months. After a second examination, it turned out that the level of calcium became normal. Now I am calm for my daughter and for the state of her body!

Christina, 37 years old

Buying a medication

You can buy Calcium Sandoz in various pharmacies at the price of package No. 10 with a dosage of 500 mg from 170 to 280 rubles.

The cost of package No. 10 with a dosage of 100 mg ranges from 320 rubles to 410 rubles.

Drug analogues:

• calcium gluconate;
• calcium glycerophosphate;
• Vitrum-calcium;
• CalViv.

pharmachologic effect

Oral calcium preparation. Calcium is a vital mineral element necessary for maintaining the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca 2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, anti-rachitic, anti-inflammatory and anti-allergic 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 provides 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.

Pharmacokinetics

Suction

Approximately 25-50% of the ingested dose of calcium is absorbed mainly in the proximal small intestine and enters the exchange calcium depot.

Distribution and metabolism

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

breeding

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. Through the intestines, both unabsorbed calcium and that of its absorbed part, which is excreted with bile and pancreatic secretions, are excreted.

Indications

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

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

- allergic reactions (maintenance therapy);

- osteomalacia (as an addition to the main therapy, including with vitamin D 3).

Dosing regimen

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

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

In severe cases or with an increased need for calcium (for example, in the treatment of bisphosphonates), it is possible to increase the dose to 2000 mg / day.

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

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

Side effect

Very rarely (<1/10 000): hypersensitivity reactions, incl. rash, itching, urticaria, hypercalcemia. In isolated cases, systemic allergic reactions (anaphylactic reactions, facial edema, angioedema) have been reported. Several medical publications have reported the development of hypercalciuria with calcium supplements.

Rare (>1/10,000,<1/1000): flatulence, constipation, diarrhea, nausea, vomiting, epigastric pain.

When taken in high doses(2000 mg / day when taken daily for several months), headache, fatigue, thirst, polyuria may be observed.

Contraindications for use

- hypercalcemia;

- hypercalciuria;

- chronic renal failure;

- nephrourolithiasis;

- nephrocalcinosis;

- phenylketonuria;

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

- Hypersensitivity to the components of the drug.

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 abnormalities in the development of the fetus.

Use in children

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 of calcium intoxication is when taking calcium preparations 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 restored.

In chronic overdose, when signs of hypercalcemia are detected, hydration is carried out at the initial stage with a 0.9% sodium chloride solution. Loop diuretics, such as furosemide, may be used to enhance calcium excretion and to avoid tissue edema (eg, in congestive heart failure). In this case, you should refrain from using thiazide diuretics.

In patients with renal insufficiency, 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 movements.

drug interaction

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 the absorption of calcium. When administered 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 preparations, 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 ingestion of calcium supplements.

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

Systemic corticosteroids reduce calcium absorption. With their simultaneous use, it may be necessary to increase the dose of calcium carbonate + calcium lactogluconate effervescent tablets.

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

With simultaneous ingestion of bisphosphonate or sodium fluoride, these drugs should be taken at least 3 hours before taking calcium carbonate + calcium lactogluconate effervescent tablets, since absorption from the gastrointestinal tract of bisphosphonate or sodium fluoride may decrease.

Calcium absorption from the gastrointestinal tract may decrease with the simultaneous intake of certain types of food 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.

Terms of dispensing from pharmacies

The drug is approved for use as a means of OTC.

Terms and conditions of storage

The drug should be stored in a tightly closed container at a temperature not exceeding 30°C. Shelf life - 3 years.

Application for violations of kidney function

Contraindicated in severe renal failure

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

special instructions

In patients with mild hypercalciuria (exceeding 300 mg or 7.5 mmol / day), with mild or moderately impaired renal function, and with a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or cancel it. Patients with a tendency to form stones in the urinary tract are advised to increase fluid intake.

In patients with impaired renal function, the intake of calcium salts should be carried out under medical supervision. Serum calcium and phosphate levels need to be monitored.

High doses of vitamin D or its derivatives should be avoided when taking calcium supplements, unless there are specific indications for this.

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

- 1 500 mg effervescent tablet contains 2.976 mmol (equivalent 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 for disposal of unused product

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

Influence on the ability to drive vehicles and control mechanisms

Calcium Sandoz ® Forte does not affect the ability to drive a car or work with mechanisms.

Lack of calcium leads to rather unusual symptoms of unreasonable irritability and anxiety, fatigue. To prevent the undesirable consequences of a lack of Ca + ions in the body, doctors recommend taking Calcium Sandoz Forte. In order to help the body not bring unnecessary problems, it is important to read the instructions, take into account a number of restrictions associated with taking the drug.

A macronutrient, along with other useful substances, is necessary for a person to ensure its normal functioning, especially for the strength of bone structures and teeth. The body of a healthy person (adult) contains approximately 1000 g of calcium. The result of a sufficient dose of a chemical can be called the absence of problems with blood clotting, the normal functioning of muscles and the thyroid gland, and the free passage of nerve impulses.

The lack of a mineral that can be washed out of skeletal structures signals the following symptoms:

• Weakness and increased fatigue;
• Drying of the skin, peeling of the skin;
• Fragility of nails, destruction of tooth enamel (caries);
• The appearance of bone pain, cramps, numbness of the fingers;
• The development of osteoporosis due to increased bone fragility;
• Signs of heart failure, heart problems;
• Increased nervous excitability, thyroid diseases.

Doctors consider the deficiency of Ca + ions to be especially dangerous in young children.

The situation threatens with growth retardation, as well as the development of the child, a violation of the formation of bone tissues and teeth, the lens of the eye undergoes pathological changes. The most dangerous sign of hypocalcemia in childhood is the phenomenon of poor blood clotting.

How to replenish macronutrient reserves

For the treatment of a life-threatening condition, the doctor prescribes Sandoz Forte Calcium along with vitamin D. Preparations containing any dosage of the macronutrient are used to provide a daily amount of calcium of at least 1500-2000 mg. The doctor selects the dosage of vitamin D taking into account the individual characteristics of the patient. The degree of effectiveness of therapy will be indicated by the absence of signs of hypocalcemia with a normal level of calcium according to the results of a blood test.

Compensation for the lack of Ca + ions is facilitated by the appointment of a special diet enriched with foods with a high mineral content, together with medication. The doctor selects a certain dosage of drugs with calcium in order to avoid oversaturation of the patient's body with a useful element, the excess of which is just as dangerous as its lack.

The macroelement that has entered the body is spent on various life processes. Replenishment of its reserves is facilitated by taking Calcium Sandoz Forte, and the price of an important medicine for the body depends on the dosage of the element:

1. The cost of 20 white tablets produced in France with a dosage of 500 mg ranges from 280-474 rubles;
2. 20 soluble tablets Calcium Sandoz Forte with a dosage of 1000 mg can be purchased at a price of 512-737 rubles.

It is important to consider that disturbed calcium metabolism adversely affects the functioning of all human organs and systems. The need for a trace element does not fade from the time of conception until the moment of death.

General information about the drug

Calcium Sandoz Forte is a combined drug designed to regulate the exchange of Ca + ions. The instruction to the drug informs that it is part of the osteoporosis therapy program to restore normal metabolism, which removes the deficiency in this element.

Most often, the pharmacy chain offers Calcium Sandoz Forte tablets in polypropylene cases of 20 pieces. The bottle is packed in a cardboard box. According to doctors, taking Calcium Sandoz Forte is especially relevant for fractures and osteoporosis. The medication helps to accelerate the fusion of bones, as evidenced by the reviews of traumatologists. In the treatment of osteoporosis in children, the rapidly dissolving form of ionized salts shows higher bioavailability than calcium gluconate.

Important Points

The daily need for a chemical element at different stages of life is not the same, but increases during puberty. Upon completion of the process of skeletal formation, the need for Ca + ions decreases, but increases sharply with high physical activity. Treatment with the drug is relevant during pregnancy and breastfeeding, hormonal disorders associated with the thyroid gland or taking glucocorticosteroids.

One of the best drugs that normalize human calcium metabolism is Calcium Sandoz Forte, which should be taken strictly according to the doctor's prescription, guided by the instructions for the medication.

Uncontrolled medication can lead to undesirable consequences, cause allergic manifestations.

According to patients, the soluble product not only eliminates the lack of a mineral, but also perfectly quenches thirst, has a pleasant taste.

The purchase of vials of 1000 mg tablets is cheaper than 500 mg effervescent tablets, but you should not forget about contraindications

Features of the action of the drug

Pharmacodynamics

According to the information from the instructions for the correct use of Calcium Sandoz Forte, the drug is taken orally (by mouth). A sufficient amount of the mineral necessary for normal life maintains the balance of electrolytes in the human body, which contributes to the proper functioning of organs and life support systems. Calcium Sandoz Forte is intended to eliminate the deficiency of the element that has arisen against the background of the following conditions leading to the leaching of the element from the body:

• Consequences of strict diets and abuse of carbonated drinks;
• Long-term use of drugs that interfere with the absorption of calcium;
• Diseases that enhance the absorption of the mineral, excess hormones;
• Insufficient content of vitamin D in the body.

Appointment Calcium Sandoz Forte is relevant for inflammatory processes, rickets, allergic reactions. The instruction to the preparation notifies that the presence of the active substance of two calcium salts (lactogluconate and carbonate) gives the effervescent tablets the ability to quickly dissolve in water. Due to the transformation of the active substance into active Ca + ions, the resulting solution is quickly assimilated.

A drink with a pleasant taste is used not only during the treatment of acute or chronic forms of hypocalcemia, but also for the prevention of its development. Rapidly soluble ionized Ca + salts are also necessary for violations of metabolic processes in bone tissues.

Pharmacokinetics

• absorption process. Up to 50% of the mineral element important for life is actively absorbed in the widest part of the small intestine (proximal section). Then the dose taken orally accumulates to participate in metabolic processes.
• How is distribution done? Almost all reserves of the element contain tissues of human teeth and bones, only one percent of the substance is dissolved in the internal fluids of the body. Half of this volume in the composition of the blood is represented by an ionized form of a physically active substance, part of which actively interacts with proteins.
• Excretion method. The evacuation of metabolites of calcium salts is carried out mainly by the intestines (80%), the rest is excreted by the kidneys.

In reviews of the drug, doctors warn of an increase in the daily intake of calcium with age. An adult body needs from 1000 to 1500 mg of an element per day. It does not matter from what sources the mineral comes - from food or drugs. When 1000 mg of calcium enters the body with food, only about 300 mg of the substance is absorbed.

Indications

1. Pregnant and lactating mothers, children during the formation of the musculoskeletal framework for the treatment and prevention of hypocalcemia;
2. Women at the stage of menopausal restructuring and after it for the treatment, as well as the prevention of osteoporosis;
3. People who are prone to allergy symptoms, as part of a health-restoring therapy;
4. With insufficient mineralization of bone tissue for the treatment of osteomalacia, as well as a lack of a mineral from food.

A drug based on calcium salts is not prescribed to children under 3 years of age due to the lack of information on the safety of treatment for babies. When treating nursing mothers, it should be borne in mind that Ca + ions are able to penetrate into breast milk. The safe dose for pregnant women is 1500 mg, its excess is dangerous for the development of the fetus.

Contraindications

Instructions for use of Calcium Sandoz Forte contains a list of diseases in which the appointment of a medication is prohibited. Treatment with effervescent tablets and dosage should be prescribed by a physician to prevent the risk of developing hypercalcemia.

The instruction to the drug contains special instructions for the treatment of patients with kidney pathologies, urolithiasis. Therapy requires regular monitoring of the fact of the evacuation of salts with urine in order to correct the dose taken in time or cancel the medicine.

One tablet, pre-dissolved in a glass of water, is taken orally without focusing on food intake.

With an increased need for a trace element, for example, the appointment of bisphosphonates, a double daily dose of 2000 mg is allowed.

The course of therapy with Calcium Sandoz Forte is designed for 4-6 weeks, the duration of taking tablets for prophylactic purposes is decided by the doctor on an individual basis.

Additional information from the instructions

• Effects. When starting treatment with an instant drug containing a duet of calcium salts, it is important to familiarize yourself with the list of possible undesirable effects of treatment. Instructions for use Calcium Sandoz Forte will introduce you to the list of side effects, the possible consequences of increased doses.
• Interaction. A separate section of the instructions is devoted to the features of the interaction of the drug with other drugs. It is important to pay attention to the combination of effervescent tablets with vitamin D, which enhances the process of calcium absorption, slows down the action of calcium channel blockers.

According to the instructions for the use of tablets, an overdose of the element threatens to disrupt the water-electrolyte balance. It is urgent to stop therapy in order to restore balance

A drug that replenishes calcium deficiency in the body

Active ingredients

Calcium carbonate (calcium carbonate)
- calcium lactogluconate (calcium lactate gluconate)

Release form, composition and packaging

◊ Effervescent tablets

Excipients: citric acid - 1662 mg, macrogol 6000 - 125 mg, orange flavor - 30 mg (orange flavor contains sulfur dioxide (E220), butylhydroxyanisole (E320), sorbitol), aspartame - 30 mg, - 250 mg.

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

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

10 pieces. - polypropylene cases (1) - packs of cardboard.
20 pcs. - polypropylene cases (1) - packs of cardboard.

pharmachologic effect

Oral calcium preparation. Calcium is a vital mineral element necessary for maintaining the balance of electrolytes in the body and the adequate functioning of numerous regulatory mechanisms. Replenishes Ca 2+ deficiency in the body, participates in phosphate-calcium metabolism, has vitamin, anti-rachitic, anti-inflammatory and action.

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 provides 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.

Pharmacokinetics

Suction

Approximately 25-50% of the ingested dose of calcium is absorbed mainly in the proximal small intestine and enters the exchange calcium depot.

Distribution and metabolism

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

breeding

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. Through the intestines, both unabsorbed calcium and that of its absorbed part, which is excreted with bile and pancreatic secretions, are excreted.

Indications

• prevention and treatment of calcium deficiency (including pregnancy, lactation, a 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 the main therapy, including D 3).

Contraindications

• hypercalcemia;
• hypercalciuria;
• chronic renal failure;
• nephrourolithiasis;
• nephrocalcinosis;
• phenylketonuria;
• sucrase / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;
• hypersensitivity to the components of the drug.

With the simultaneous use of effervescent calcium carbonate + calcium lactogluconate tablets and tetracycline preparations, 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 ingestion of calcium supplements.

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

Systemic corticosteroids reduce calcium absorption. With their simultaneous use, it may be necessary to increase the dose of calcium carbonate + calcium lactogluconate effervescent tablets.

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

With simultaneous ingestion of a bisphosphonate or these drugs should be taken at least 3 hours before taking calcium carbonate + calcium lactogluconate effervescent tablets, since absorption from the gastrointestinal tract of bisphosphonate or sodium fluoride may decrease.

Calcium absorption from the gastrointestinal tract may decrease with the simultaneous intake of certain types of food 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.

special instructions

In patients with mild hypercalciuria (exceeding 300 mg or 7.5 mmol / day), with mild or moderately impaired renal function, and with a history of urolithiasis, regular monitoring of urinary calcium excretion is required. If necessary, reduce the dose of the drug or cancel it. Patients with a tendency to form stones in the urinary tract are advised to increase fluid intake.

In patients with impaired renal function, the intake of calcium salts should be carried out under medical supervision. Serum calcium and phosphate levels need to be monitored.

High doses of vitamin D or its derivatives should be avoided when taking calcium supplements, unless there are specific indications for this.

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

• 1 500 mg effervescent tablet contains 2.976 mmol (equivalent 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 for disposal of unused product

There is no need for special precautions when destroying unused Calcium Sandoz Forte.

Influence on the ability to drive vehicles and control mechanisms

The drug Sandoz Calcium Forte does not affect the ability to drive a car or work with mechanisms.

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 abnormalities in the development of the fetus.

Application in childhood