Kaltsy-Dz-MICK

General characteristics. Structure:

Active ingredients: 66,7 ME cholecalciferols (D3 vitamin), 416,3 mg of calcium of a carbonate (in terms of calcium – 166,7 mg).

Excipient: potato starch.

Structure of a cover of a gelatin capsule: gelatin pharmaceutical, glycerin, sodium lauryl sulfate, titanium dioxide, the water purified "a yellow sunset" (E-110).

The combined drug regulating exchange of calcium and phosphorus.

Pharmacological properties:

Pharmacodynamics. Kaltsy-D3-MICK - the combined drug regulating exchange of calcium and phosphorus.

Calcium – the vital mineral element necessary for maintenance of balance of electrolytes in an organism and adequate functioning of regulatory mechanisms. Calcium the carbonate participates in formation of a bone tissue, is necessary for a mineralization of teeth, regulation of nerve conduction, muscular contractions, maintenance of stable cordial activity and is a component of system of a blood coagulation. Calcium (in the ionized form and in the form of complexes) plays a key role in division and differentiation of cells, carrying out nervous impulses and in a cycle reduction relaxation (together with tropine) smooth and cross-striped muscles, transmembrane ionic reactions with participation of the selection calcium channels, activity of the neuroselection bodies, development and effects of a number of hormones, enzymes and other proteinaceous, and also nonprotein biologically active agents.

D3 vitamin stimulates absorption of calcium and phosphorus in intestines, a reabsorption of calcium and phosphorus in kidneys, calcium transport through membranes and cells, development of immune system, proliferation and differentiation of cells, synthesis of lipids and a number of hormones, functional activity of cardiovascular system and digestive tract, reduces the level of parathyroid hormone in blood. He is necessary for normal functioning of epithelial bodies, takes part in ATP synthesis.

D3 vitamin and its active metabolites possess multidimensional action on a bone tissue: increase absorption of calcium in intestines, stimulating synthesis of kaltsiysvyazyvayushchy proteins; raise a calcium reabsorption in renal tubules; activate processes of a remodulyation of a bone by increase in synthesis of collagen I and proteins of a matrix, by means of activation of synthesis of osteoblasts; improve quality of a bone, influencing activity of osteoclasts; regulate secretion of parathyroid hormone.

Use of the combined drug, calciferous and D3 vitamin is justified as D3 vitamin increases absorbability of calcium in intestines and combined use of calcium and D3 vitamin interferes with increase in production of parathyroid hormone (PTG) which is a stimulator of the raised bone resorption (washing away of calcium from bones).

Thus, Kaltsy-D3-MICK regulates exchange of calcium and phosphates, reduces a resorption and increases density of a bone tissue, compensates for the deficiency of calcium and D3 vitamin of an organism, strengthens absorption of calcium in intestines and a reabsorption of phosphates in kidneys, promotes a mineralization of bones.

Pharmacokinetics. Absorption of calcium happens in 12-perstny, lean and tolstoykishka. This process is carried out with participation of two mechanisms: an aktivnoyabsorbtion and passive diffusion with which participation it is soaked up less 10%postupayushchego with element food. The main regulator of active absorption yavlyaetsyametabolit vitamin D – the calcitriol stimulating biosynthesis calcium of svyazyvayushchikhbelok in intestines enterocytes. The calcium which came after absorption to a sistemnuyutsirkulyation is distributed on bodies and systems and first of all comes to a bone.

In physiological conditions removal of calcium from an organism (except the part allocated with a stake, not soaked up in intestines) sostavlyaetprimerno 250 – 300 mg a day which include 140 – 180 mg, not podvergnuvshikhsyareabsorbtion in kidneys and coming to urine, and also 80 – 100 mg, экскретируемыхв intestines with bile and a pancreatic secret.

Absorption of D3 vitamin happens in a small intestine. 50-70% of the accepted vitamin dose Obychnousvaivatsya. Maximum it kontsentratsiyadostigatsya in 8-18 hours. From a blood-groove about 70% of D3 vitamin to a pogloshchayetsyapechenye where its metabolizing is carried out. The formed metabolite (25 hydroxycholecalciferol) is transported in kidneys where there are obrazovaniyebiologichesk of active connections among which the greatest fiziologicheskoyeznacheniye have 1,25 dihydroxycholecalciferol (1,25 (IT) 2 D3) i24,25-dihydroxycholecalciferol (24,25 (IT) 2D3).

Formation of digidroksikholekaltsiferol is broken a prikhronichesky renal failure, at purpose of inhibitors of a belkovogosintez (Actinomycinum, glucocorticoids), at prolonged use of a fenobarbitalaa of dipheninum.

D3 vitamin has cumulative properties. It Onnakaplivatsya in a liver in not parynchemal cells from where it is transported vgepatotsita in which there is its metabolizing.

Use of high doses of D3 vitamin is inexpedient, so каквитамин in these cases inhibits education biologically active a soyedineniyvitamina of D3. At the same time in an organism percentage of a neprevrashchennogovitamin of D3 which is exposed to oxidation increases and by that the risk of a vozniknoveniyad-hypervitaminosis increases.

Indications to use:

As treatment-and-prophylactic means of Kaltsy-D3-MICK it is applied:

- at the conditions of deficit of calcium and D3 vitamin in an organism connected with defective food when receipt with food of calcium and cholecalciferol is not enough;

- at the increased need of an organism for calcium and D3 vitamin at pregnancy and during breastfeeding, and also at children 12 years during intensive growth are more senior;

- for prevention of osteoporosis (menopauzny, senile, steroid, idiopathic, etc.) and its complications (fractures of bones), as addition to any specific therapy of osteoporosis.

Route of administration and doses:

To adults and children 12 years are more senior appoint 2-3 capsules 2 times a day in the morning and in the evening, is preferential during food. The dosing mode for children aged up to 12 years according to recommendations of the doctor.

Features of use:

Drug should be used with care at patients with a soft and moderate renal failure (periodic control of release of calcium with urine and behind calcium level in plasma is necessary). Besides, it is necessary to carry out control of release of calcium with urine at the patients having in the anamnesis stones in kidneys for the purpose of a hypercalcuria exception.

At patients who at the same time accept cardiac glycosides and/or diuretics it is necessary to control concentration of calcium and creatinine in blood serum. In case of the calciuria exceeding 7,5 mmol/days (300 mg/days) it is necessary to reduce a dose or to stop administration of drug.

In order to avoid overdose, it is necessary to consider additional intake of D3 vitamin from other sources. Not to apply along with vitamin complexes, calciferous and D3 vitamin.

At elderly people the need for calcium makes 1500 mg/days, in D3 vitamin – 500-1000 ME/days.

Use of high doses of D3 vitamin is inexpedient as vitamin B these cases inhibits formation of biologically active compounds of D3 vitamin. At the same time in an organism percentage of not turned D3 vitamin which is exposed to oxidation increases and by that the risk of emergence of a D-hypervitaminosis increases.

Pregnancy and lactation. At purpose of drug during pregnancy it is necessary to consider that the daily dose of calcium should not exceed 1500 mg, and cholecalciferol - 600 ME. The overdose during pregnancy can lead to disturbance of mental and physical development of the child.

Cholecalciferol and its metabolites can be emitted with breast milk. Therefore at purpose of drug of Kaltsy-D3-MICK it is necessary to consider the total quantity of calcium and cholecalciferol coming to mother's organism within a day.

Side effects:

From the alimentary system: lock or diarrhea, meteorism, nausea, abdominal pain.

From a metabolism: seldom – a hypercalcemia and a hypercalcuria.

Others: allergic reactions.

Interaction with other medicines:

Activity of cholecalciferol can decrease at its simultaneous use with Phenytoinum or barbiturates.

At simultaneous use of Kaltion-D3-MICK and cardiac glycosides control of an ECG and clinical state since drugs of calcium can exponentiate therapeutic and toxic effects of cardiac glycosides is necessary.

Calcium can strengthen adsorption of drugs of a tetracycline row and fluorinated drugs therefore Kaltsy-D3-MICK should take for 3 h to or after the specified drugs.

Glucocorticosteroids reduce calcium absorption.

Holestiramin and purgatives on the basis of mineral or vegetable oil reduce D3 vitamin absorption.

At simultaneous use of diuretics of a thiazide row the risk of emergence of a hypercalcemia since they increase a canalicular reabsorption of calcium increases. Furosemide and other loopback diuretics, on the contrary, increase calcium removal by kidneys.

Contraindications:

• hypersensitivity;

• hypercalcemia (including as result of a hyperparathyreosis (primary or secondary));

• hypercalcuria;

• D3 hypervitaminosis;

• the decalcifying tumors, such as myeloma, bone metastasises, sarcoidosis;

• urolithiasis;

• the osteoporosis caused by an immobilization;

• atherosclerosis.

Overdose:

Symptoms: anorexia, thirst, polyuria, nausea, vomiting, dizziness, weakness, headache, hypercalcuria, hypercalcemia, irritability, sleep disorders.

Treatment: it is necessary to cancel drug immediately. Neobkhodimovvedeniye in an organism of a large amount of liquid, use of petlevykhdiuretik (for example, furosemide), glucocorticosteroids, a calcitonin, bisfosfonat, a diet with calcium restriction.

Storage conditions:

Store in the dry place protected from light at a temperature from 15 to 25 °C. To store in the place, unavailable to children! Period of validity 2 years.

Issue conditions:

Without recipe

Packaging:

On 10 capsules in a blister strip packaging from a film of polyvinyl chloride brand and folgialyuminiyevy. On 6 planimetric upakovkivmesta with the application instruction on state and Russian языкев a pack from a cardboard.