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- Product ID: Conventional Calcium + Vitamin D3
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Adcal-D Tablet — Calcium Carbonate + Vitamin D3 200 IU
Generic Name: Calcium Carbonate + Cholecalciferol (Vitamin D3) 200 IU
Manufacturer: Beximco Pharmaceuticals Ltd.
Drug Class: Calcium and Vitamin D3 Supplement
Dosage Form: Tablet
Prescription Status: Prescription / OTC (as directed by physician)
Role of Calcium and Vitamin D3
Calcium is the primary mineral in bone, comprising 99% of skeletal calcium. Adequate dietary calcium is essential for bone mineralisation, muscle contraction, nerve transmission, and vascular function. Calcium carbonate provides the highest elemental calcium content (~40%) of all calcium salts.
Vitamin D3 (Cholecalciferol) is the natural form of vitamin D produced in skin on sun exposure. It is converted in the liver to 25-hydroxyvitamin D and then in the kidney to the active form 1,25-dihydroxyvitamin D (calcitriol), which enhances intestinal calcium and phosphate absorption, promotes bone mineralisation, and regulates parathyroid hormone (PTH) levels.
Critical Relevance to Diabetes
Vitamin D deficiency is highly prevalent in patients with Type 2 Diabetes and is independently associated with:
- Insulin resistance — vitamin D receptors on beta cells and peripheral tissues modulate insulin secretion and sensitivity
- Higher risk of osteoporosis — diabetic patients have increased fracture risk due to glucosuria-related calcium wasting, reduced physical activity, and peripheral neuropathy (fall risk)
- Diabetic patients on metformin long-term may have impaired vitamin B12 and calcium absorption
- Pioglitazone and insulin therapy are associated with reduced bone mineral density
- Vitamin D supplementation may improve glycaemic control in vitamin D-deficient patients with T2DM
Indications
- Prevention and treatment of calcium and vitamin D3 deficiency
- Osteoporosis prevention and adjunct treatment (with antiresorptive agents)
- Osteomalacia and rickets
- Hypoparathyroidism
- Supplementation during pregnancy and breastfeeding
- Elderly patients with limited sun exposure and dietary calcium intake
- Diabetic patients on long-term metformin, insulin, or thiazolidinediones
- Patients on long-term corticosteroids (which impair calcium absorption and accelerate bone loss)
Dosage and Administration
| Indication | Usual Dose | Notes |
|---|---|---|
| Supplementation / Prevention | 1–2 tablets daily | With meals to improve absorption |
| Osteoporosis adjunct | As prescribed (typically 2 tablets daily) | Take with or after food |
| Renal impairment (mild-moderate) | Use with caution; monitor serum calcium | Avoid in severe renal failure |
Take calcium carbonate tablets with meals — gastric acid enhances absorption. Space doses at least 2 hours apart from iron, thyroid, or bisphosphonate medications.
Contraindications
- Hypercalcaemia or hypercalciuria
- Nephrolithiasis (calcium-containing kidney stones)
- Severe renal impairment (eGFR <30) without specialist guidance
- Hypervitaminosis D
- Hypersensitivity to any component
Drug Interactions
| Drug / Class | Effect |
|---|---|
| Bisphosphonates (alendronate, risedronate) | Calcium impairs absorption — space by at least 2 hours |
| Levothyroxine (thyroid hormone) | Calcium reduces thyroid absorption — take 4 hours apart |
| Iron supplements | Mutual absorption interference — space by 2 hours |
| Thiazide diuretics | Reduce urinary calcium excretion — risk of hypercalcaemia |
| Digoxin | Hypercalcaemia potentiates digoxin toxicity — monitor |
| Corticosteroids | Reduce calcium absorption — supplementation particularly important |
Side Effects
- Constipation, bloating, flatulence (calcium carbonate — common)
- Nausea, gastric discomfort
- Hypercalcaemia with excessive doses: thirst, polyuria, confusion, kidney stones
- Milk-alkali syndrome with very high calcium intake (rare)
Monitoring
- Serum calcium and phosphate — periodically during long-term supplementation
- Serum 25-OH-vitamin D — to confirm adequacy (target 50–150 nmol/L)
- Renal function — in patients with existing renal impairment
- Urine calcium — if history of kidney stones
Storage
Store below 30°C. Protect from moisture. Keep out of reach of children.
Medical Disclaimer
The information provided here is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Adcal-D (Calcium + Vitamin D3) must only be used under the supervision of a qualified physician. Do not exceed recommended doses. Monitor serum calcium regularly during long-term use. DiabetesStore.com.bd does not endorse self-medication.
