Calcium + Alfacalcidol + Zinc Pharmacology

Calcium + Alfacalcidol + Zinc

About Calcium + Alfacalcidol + Zinc
N/A
Mechanism of Action of Calcium + Alfacalcidol + Zinc
N/A
Pharmacokinets of Calcium + Alfacalcidol + Zinc
N/A
Onset of Action for Calcium + Alfacalcidol + Zinc
N/A
Duration of Action for Calcium + Alfacalcidol + Zinc
N/A
Half Life of Calcium + Alfacalcidol + Zinc
N/A
Side Effects of Calcium + Alfacalcidol + Zinc
N/A
Contra-indications of Calcium + Alfacalcidol + Zinc
N/A
Special Precautions while taking Calcium + Alfacalcidol + Zinc
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
Use with caution
Children Related Information
N/A
Indications for Calcium + Alfacalcidol + Zinc
1.Osteoporosis
2.Osteomalacia
3.Hypoparathyroidism
4.Rickets
Interactions for Calcium + Alfacalcidol + Zinc
N/A
Typical Dosage for Calcium + Alfacalcidol + Zinc
2 capsule / day
Schedule of Calcium + Alfacalcidol + Zinc
N/A
Storage Requirements for Calcium + Alfacalcidol + Zinc
N/A
Effects of Missed Dosage of Calcium + Alfacalcidol + Zinc
N/A
Effects of Overdose of Calcium + Alfacalcidol + Zinc
N/A

Calcium

About Calcium
Calcium is necessary for cardiac function, muscle contraction, nervous activity, coagulation of blood and for maintaining structural integrity of cell membranes.
Plasma concentration of calcium is kept in normal range by three endocrine factors which control metabolism of calcium. These are (a) Parathyroid hormone, (b) Calcitonin, (c) Vitamin D. Calcium in plasma is bound to albumin, is complexed with anions (e.g. phosphate) and as diffusible ionic calcium. The physiological effects are exerted by ionic calcium. The predominant source of calcium is dairy products and the daily intake varies from 200 - 2500 mg. Adequate calcium intake is particularly important during periods of bone growth in childhood and adolescence and during pregnancy and lactation.
Patients with advanced renal insufficiency exhibit phosphate retention and some degree of hyperphosphataemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy and soft tissue calcification. Calcium acetate, when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the faeces.
Deficiency signs and symptoms: Osteoporosis, pathological fractures, brittle nails and hair.
Mechanism of Action of Calcium
Calcium is essential for maintaining the functional integrity of nervous, muscular, and skeletal system. It controls excitability of nerves and muscles and regulates permeability of cell membrane. It also regulates cell adhesion and maintains integrity of cell membrane. Calcium acts as intracellular messenger for hormones, autacoids, and transmitters. It is required for excitation-contraction coupling in all types of muscle and excitation-secretion coupling in exocrine and endocrine glands. It is essential for release of transmitters from nerve endings and other release reactions. It is also essential for impulse generation in heart and determines level of automaticity and
A-V conduction. Calcium is also required for blood-coagulation.
Pharmacokinets of Calcium
Absorption: Actively absorbed from gastrointestinal tract in an ionized form; and vitamin D in it`s active form is required for calcium absorption, Distribution: Distributed mainly in to skeletal tissue (99%) and 1% is distributed equally between the intracellular and extra cellular fluid. CSF levels are about half of the serum calcium levels, Metabolism: Not significantly metabolized in the body, Excretion: Excreted mainly through faeces and a small amount is excreted through urine.
Onset of Action for Calcium
N/A
Duration of Action for Calcium
N/A
Half Life of Calcium
N/A
Side Effects of Calcium
1.Constipation
2.Bloating
3.Excess gas
4.Anorexia
5.Nausea
6.Vomiting
7.Abdominal pain
8.Thirst
9.Hypercalcaemia
10.Polyuria
11.Dry mouth
12.Delirium
13.Confusion
Contra-indications of Calcium
1.Renal calculi
2.Hypophosphataemia
3.Hypercalcaemia
4.Ventricular fibrillation.
Special Precautions while taking Calcium
1.Renal impairment
2.Cardiac diseases
3.Sarcoidosis
4.Cor pulmonale
5.Respiratory acidosis
6.Respiratory failure
7.End stage renal failure
8.Hypoparathyroid patients
9.Digitalized patients
10.Prolonged use of therapeutic amounts.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Calcium
1.Hypocalcaemia
2.Calcium and vitamin D deficiency
3.Calcium deficiency during pregnancy and lactation
4.Rickets
5.Prevention of osteoporosis in postmenopausal women
6.Chronic renal failure.
Interactions for Calcium
N/A
Typical Dosage for Calcium
Oral: 500mg to 2g daily in two to four divided doses.
Hypocalcaemia:
Adults: 1g daily. Increases to 2g daily if required.
Prevention of osteoporosis: 1 to 1.5g daily.
Children: 45 to 65mg/kg daily.
Neonates: 50 to 150mg/kg and should not exceed 1g.

Schedule of Calcium
N/A
Storage Requirements for Calcium
Store in a well closed container in a cool and dry place. Protect from light.


Effects of Missed Dosage of Calcium
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Calcium
Remove calcium from stomach by induced emesis and gastric lavage. Provide symptomatic treatment and supportive measures.

Alfacalcidol

About Alfacalcidol
Nutritional supplement,Vitamin D derivative, Antihypoparathyroid, Antihypocalcemic.
Mechanism of Action of Alfacalcidol
Alfacalcidol is a prodrug of Vitamin D and is rapidly hydroxylated in the liver in to calcitriol. Vitamin D exerts it`s action by influencing calcium homoeostasis. It increases the intestinal absorption of calcium and phosphate. It binds to the cytoplasmic Vitamin D receptor and translocates to the nucleus and thus increases the synthesis of specific m RNA and regulates protein synthesis. It increases the synthesis of a carrier protein for calcium called "calbindin" or calcium binding protein. Activation of Vitamin D receptor enhances endocytotic capture of calcium and it`s transport across duodenal mucosal cells in a vesicular form. Vitamin D promotes resorption of calcium and phosphate from bone by enhancing recruitment and differentiation of osteoclast precursors in the bone remodeling units. It helps in bone mineralization.
Pharmacokinets of Alfacalcidol
Absorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form. It is stored in adipose tissue and liver. Metabolism: It is hydroxylated in to calcitriol in liver. Excretion: Excreted mainly through bile.

Onset of Action for Alfacalcidol
N/A
Duration of Action for Alfacalcidol
N/A
Half Life of Alfacalcidol
N/A
Side Effects of Alfacalcidol
1.Hypercalcaemia
2.Fatigue
3.Weakness
4.Diarrhoea
5.Vomiting
6.Sluggishness
7.Albuminuria
8.Polyuria
9.Calcification of soft tissues (blood vessels, parenchymal organs including heart)
10.Renal stones
11.Growh retardation in children
12.Hypertension
13.Anorexia
14.Nausea
15.Constipation
16.Hyperphosphataemia.
Contra-indications of Alfacalcidol
1.Hypercalcaemia
2.Hypervitaminosis D
3.Hyperphosphataemia (except when occurring with hypoparathyroidism
4.Hypermagnesaemia.
Special Precautions while taking Alfacalcidol
1 Renal impairment
2.Hypercalciurea
3.Renal stones
4.Coronary diseases.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Alfacalcidol
1.Rickets and Osteomalacia
2.Hypoparathyroidism with bone disease
3.Renal osteodystrophy
4.Osteoporosis
Interactions for Alfacalcidol
Digitallis preparations: Cardiac arrhythmias precipitated.
Thiazide Diuretics: Hypercalcaemic response enhanced.
Barbiturates & other enzyme inducing anticonvulsants: Reduce efficacy.
Minteral Oil: Prolonged use reduces efficacy.
Cholestyramine, Cholestipol, Sucralfate, Aluminium based Antacids: Reduced efficacy by decreasing absorption of alfacalcidol.
Magnesium based Antacids or Laxatives: Hypermagnesaemia in those on chronic renal dialysis.
Typical Dosage for Alfacalcidol
Oral:
Starts with 1mcg daily. Adjusted based on patients response to 2mcg daily if required.
Children over 20kg: Starts with 1mcg daily. Adjusted based on patient`s response.
Children under 20kg: 0.5mcg daily or 0.05mcg/kg/day
Schedule of Alfacalcidol
C1
Storage Requirements for Alfacalcidol
Store in a well closed container in a cool place. Protect from light and excess heat. Keep out of reach of children.
Effects of Missed Dosage of Alfacalcidol
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Alfacalcidol
Provide supportive and symptomatic treatment. Stops the treatment and starting a low calcium diet. Increases the fluid intake and administer Loop diuretics like furosemide may be given with saline I.V. infusion to increase calcium excretion. Calcitonin may decrease hypercalcaemia.

Zinc

About Zinc
Trance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.
Mechanism of Action of Zinc
Zinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.
Pharmacokinets of Zinc
Absorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.
Onset of Action for Zinc
N/A
Duration of Action for Zinc
N/A
Half Life of Zinc
N/A
Side Effects of Zinc
1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes
Contra-indications of Zinc
N/A
Special Precautions while taking Zinc
1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
N/A
Indications for Zinc
1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia
Interactions for Zinc
Fluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.

Typical Dosage for Zinc
Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of Zinc
N/A
Storage Requirements for Zinc
Store at a temperature below 30 degree C
Effects of Missed Dosage of Zinc
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Zinc
Provide symptomatic treatment and supportive measures

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