Cercal

Cercal Uses, Dosage, Side Effects, Food Interaction and all others data.

Calcium citrate is a salt typically used as a source of calcium in a variety of over the counter supplements.

Increases plasma calcium levels leading to a decrease in calcium flux and increase in calcium deposition into bone

Magnesium citrate is a low volume and osmotic cathartic agent. The cathartic action works primarily through the high osmolarity of the solution which draws large amounts of fluid into space where is used. Magnesium citrate is considered by the FDA as an approved inactive ingredient for approved drug products under the specifications of oral administration of a maximum concentration of 237 mg. It is also considered as an active ingredient in over-the-counter products.

The onset of action can be as early as 30 minutes after administration with a mean onset time of approximately 2 hours and a maximum action of 4 hours. The effect of magnesium citrate is highly dependent on the individual's hydration status.

Mecobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.

Cercal
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Cercal
Generic	Zinc Sulphate + Vitamin D3 / Cholecalciferol + Magnesium Citrate + Calcium Citrate + Vitamin B5 / Pantothenic Acid + Vitamin B9 / Folic Acid / Folate + Mecobalamin
Weight	25mg
Type	Tablet
Therapeutic Class
Manufacturer	Ceras Pharmaceutical
Available Country	India
Last Updated:	September 19, 2023 at 7:00 am

Uses

Calcium citrate is an ingredient found in a variety of supplements and vitamins.

For use as an over the counter calcium supplement.

Magnesium citrate is a laxative used in bowel preparation for colonoscopy or as a magnesium supplement.

Magnesium citrate has been used in bowel preparations prior to a colonoscopy as a cathartic agent.

It is also used in over-the-counter products to relieve occasional constipation.

Magnesium citrate can be one of the forms used for the administration of dietary supplements.

Mecobalamin is used for-

Peripheral Neuropathies
Diabetic Neuropathy
Verteberal Syndrome
Nerve Compression Syndrome
Multiple sclerosis
Amyotrophic lateral sclerosis
Parkinson’s disease
Alzheimer’s disease
Diabetic retinopathy
Entrapment neuropathy
Drug induced neuropathy
Megaloblastic anemia due to Vitamin B12 deficiency

Cercal is also used to associated treatment for these conditions: Calcium Deficiency, Deficiency of Vitamin D3, Deficiency, Vitamin D, Folate deficiency, Hypocalcemia, Iron Deficiency (ID), OsteoporosisMigraineVitamin B12 Deficiency, Nutritional supplementation

How Cercal works

Calcium citrate increases plasma calcium levels. This reduces calcium flux from osteocyte activity by reducing the secretion of parathyroid hormone (PTH) . Calcium does this by stimulating a G-protein coupled calcium receptor on the surface of parathyroid cells. The reduction in calcium flux increases the amount of calcium deposited in bone resulting in an increase in bone mineral density. The reduction in PTH secretion also reduces the amount of vitamin D metabolized to its active form, calcidiol. Since calcidiol increases the expression of calcium dependent ATPases and transient receptor potential cation channel subfamily V member 6 (TRPV6) both of which are involved in calcium uptake from the gut, a reduction in calcidiol results in less calcium absorption. Additionally, TRPV5, the channel responsible for calcium reabsorption in the kidney, is downregulated when PTH secretion is reduced thus increasing calcium excretion via the kidneys. Another hormone, calitonin, is likely involved in the reduction of bone resorption during periods of high plasma calcium.

It mainly works through its property of high osmolality which will draw large amounts of fluid into the colonic lumen. There is also a possible stimulation of fluid excretion by cholecystokinin release and activation of muscle peristalsis.

Dosage

Cercal dosage

Tablet: The usual adult dosage is one 500 mcg tablet three times daily. The dosage should be adjusted according to the age of patient and the severity of symptoms.

Injection:

Peripheral neuropathies: The usual adult dosage is one ampoule equivalent to 500 mcg of Mecobalamin, administered intramuscularly or intravenously three times a week.The dosage should be adjusted according to the age of patient and the severity of symptoms.
Megaloblastic anemia: The usual adult dosage is one ampoule equivalent to 500 mcg of Mecobalamin, administered intramuscularly or intravenously three times a week. After about two months of administration, dosage should be changed to one ampoule equivalent to 500 mcg of Mecobalamin every one to three months as maintenance therapy

Side Effects

Generally Mecobalamin is well tolerated. However, a few side effects like GI discomfort (including anorexia, nausea or diarrhea) & rash may be seen after administration of Mecobalamin.

Toxicity

Patients taking more than 4g of calcium a day are at risk of hypercalcemia and metabolic alkalosis . Chronic intake of calcium supplements is associated with adverse gastrointestinal symptoms such as constipation and flatulence .

The occurrence of overdose with magnesium citrate is very unlikely but some of the signs of the presence of overdose are diarrhea or severe stomach pain.

Precaution

The medicine should not be used for months if there is no response at all after its use for a certain period of time.

Interaction

Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.

Elimination Route

The percentage of calcium absorbed varies inversely with intake . Tmax of about 3.5-5h varying with formulation .

Mean plasma concentration of magnesium after administration of oral doses of magnesium citrate are reported to be of around 0.7 mmol/L and the concentration in saliva rested in 0.28 mmol/L. In reports, it has also been proven that the absorption and bioavailability of magnesium are greater when administered in the form of magnesium citrate when compared with other forms such as magnesium ocude.

Half Life

The study of the half-life of magnesium citrate is very difficult due to the half-life of the available isotopes for magnesium.

Elimination Route

Cleared via the kidneys but largely reabsorbed (98-99%) under normal conditions .

After oral administration of magnesium citrate, there is a 40% increase in urine excretion of magnesium. Magnesium citrate is also widely eliminated via the feces because, when present in the bowel, it relaxes the bowel and pulls water into the intestine which increases bowel movement and a significant portion of this agent gets excreted by this via.