Calcium Sandoz forte

Calcium Sandoz forte – the drug used for completion of deficit of calcium.

Form of release and structure

Calcium Sandoz forte is produced in the form of tablets sparkling: round, flat, with slanted edge and slightly rough surface, from almost white till white color, with a specific slight smell (on 10 or 20 pieces in polypropylene cases, on 1 case in a cardboard pack).

Is a part of 1 tablet (respectively):

• Active agent: the ionized calcium – 500/1000 mg or 12,5/25 mmol (in the form of calcium carbonate – 875/1750 mg and a lactogluconate of calcium – 1132/2263 mg);
• Auxiliary components: hydrosodium carbonate – 250/500 mg, citric acid – 1662/3323 mg, aspartame – 30/30 mg, a macrogoal of 6000 - 125/250 mg, orange fragrance – 30/30 mg (orange fragrance contains butylhydroxyanisole (E320), sulfur dioxide (E220), sorbitol).

Indications to use

• Deficit of calcium, including arisen during pregnancy, a lactation and intensive growth at children (treatment and prevention);
• Osteoporosis (as an additional tool to specific therapy and prevention);
• Allergic reactions (the supporting treatment);
• Osteomalacy (as addition to the main therapy, including with D3 vitamin).

Contraindications

• Hypercalcuria;
• Hypercalcemia;
• Chronic renal failure;
• Fenilketonuriya;
• Nephrocalcinosis and нефроуролитиаз;
• Intolerance of fructose, deficit of isomaltase/invertase, glyukozo-galaktozny malabsorption;
• Hypersensitivity to drug components.

Sandoz forte is not recommended to apply calcium to children up to 3 years (due to the lack of data on efficiency and safety of its use for this age group of patients).

Route of administration and dosage

Calcium Sandoz forte is accepted inside, irrespective of meal. The tablet before reception should be dissolved in 200 ml (1 glass) of water.

The mode of dosing is defined by age:

• Adults and children of 10 years: 1000 mg a day;
• Children of 3-9 years: 500 mg a day.

At the increased need for calcium or for hard cases (for example, at treatment of a bisfosfonatama) increase in a daily dose up to 2000 mg is possible.

At treatment and prevention of osteoporosis by the adult and to children Calcium Sandoz forte is appointed according to the standard scheme of administration of drug.

For completion of deficit of calcium therapy duration, as a rule, makes not less than 4-6 weeks. Duration of administration of drug as a part of complex treatment of osteoporosis is defined by the doctor individually.

The daily dose of calcium at pregnancy should not exceed 1500 mg (the hypercalcemia can lead to disturbance in fetation).

Side effects

During Calcium reception Sandoz Forte development of the side effects which are shown with various frequency is possible:

• Very seldom (less than 1/10 000 cases): hypersensitivity reactions, including rash, urticaria, an itch, a hypercalcemia. In isolated cases development of the system allergic reactions which are shown as anaphylactic reactions, a face edema, Quincke's diseases is possible. Also there are messages on development of a hypercalcuria against the background of reception of additives with calcium;
• Seldom (more than 1/10 000 and less than 1/1000 cases): a lock, pain in the area epigastriums, a meteorism, diarrhea, vomiting, nausea.

At reception of high doses of Calcium Sandoz Forte (daily on 2000 mg a day for several months) development of a headache, increased fatigue, a polyuria and thirst is possible.

Special instructions

At patients with an insignificant hypercalcuria (300 mg or 7,5 mmol a day are higher), moderately or poorly expressed functional disturbances of kidneys, and also in the presence of data in the anamnesis on an urolithiasis it is regularly necessary to control calcium excretion with urine. In case of need it is necessary to lower the Calcium dose Sandoz Forte or to cancel it. Patients with tendency to education in urinary tract of concrements are recommended to increase liquid reception.

At functional disturbances of kidneys reception of salts of calcium needs to be carried out under medical observation (control of levels of phosphate and calcium in blood serum is necessary).

At Calcium use Sandoz Forte it is necessary to avoid reception of high doses of vitamin D or its derivatives if only for this purpose there are no special indications.

The patients who are on a diet with salt restriction need to consider the content of sodium as a part of sparkling tablets: 68,45 mg (2,976 mmol) of sodium in 1 tablet on 500 mg and 136,90 mg (5,95 mmol) of sodium in 1 tablet on 1000 mg.

Sparkling Calcium Sandoz Forte contains in 1 tablet 0,002 GU (grain units) therefore patients can use drug with a diabetes mellitus.

Medicinal interaction

At simultaneous use of Calcium Sandoz Forte with some medicines there can be undesirable effects:

• Estramustinum, этидронат and, perhaps, other bisfosfonata, Phenytoinum, hinolona, peroral tetracycline antibiotics and drugs of fluorine: reduction of their absorption (it is necessary to observe an interval between Calcium reception Sandoz Forte and the above-stated drugs not less than 3 hours);
• Vitamin D and its derivatives: increase in absorption of calcium;
• Vitamin D and its derivatives along with high doses of Calcium Sandoz Forte: reduction of effect of verapamil and, perhaps, other blockers of calcium channels;
• Drugs of a tetracycline row: disturbance of their absorption (it is necessary to use drugs of a tetracycline row not less than in 2 hours prior to or in 4-6 hours after Calcium reception Sandoz Forte);
• Thiazide diuretics: reduction of excretion of calcium with urine (it is necessary to carry out regular control of concentration of calcium in blood serum because of the existing risk of development of a hypercalcemia);
• System corticosteroids: decrease in absorption of calcium (increase in a dose of Calcium Sandoz Forte can be required);
• Cardiac glycosides: increase in their toxicity because of development of a hypercalcemia (it is regularly necessary to control calcium level in blood serum and to remove an ECG);
• Bisfosfonat or sodium fluoride: reduction of their absorption from digestive tract (it is necessary to observe an interval between Calcium reception Sandoz Forte and the above-stated drugs not less than 3 hours).

Absorption of calcium from digestive tract can decrease at a concomitant use with some types of food containing oxalic (for example, spinach, a rhubarb) or phytic acid (all grain) that is connected with formation of insoluble complexes with calcium ions (it is necessary to observe a break not less than 2 hours between administration of drug and food with the rich content of phytic or oxalic acid).

Terms and storage conditions

To store in the place, unavailable to children, in densely closed case at a temperature up to 30 °C.

Period of validity – 3 years.