Efercal

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

Each effervescent tablet contains-

Calcium Lactate Gluconate 1000 mgCalcium Carbonate 327 mgAscorbic Acid (Vitamin-C) 500 mgVitamin-D(as Vitamin-D3) 400 I.U.Calcium Gluconate is the gluconate salt of calcium. An element or mineral necessary for normal nerve, muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers.

Calcium carbonate is a basic inorganic salt that acts by neutralizing hydrochloric acid in gastric secretions. It also inhibits the action of pepsin by increasing the pH and via adsorption. Cytoprotective effects may occur through increases in bicarbonate ion (HCO3-) and prostaglandins. Neutralization of hydrochloric acid results in the formation of calcium chloride, carbon dioxide and water. Approximately 90% of calcium chloride is converted to insoluble calcium salts (e.g. calcium carbonate and calcium phosphate).

Calcium is used as a pharmacological agent in humans almost entirely to remedy deficiency. Adequate calcium in the blood is so vital to a wide variety of bodily functions that our internal biochemistry will not tolerate a deficiency even for short periods.

Vitamin-C is an essential component of the diet as humans cannot synthesize Vitamin-C. It is a very powerful reducing agent and plays an important part in the response of the body to stress. It is important in the defense against infections.

Efercal
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	Efercal
Generic	Calcium Lactate Gluconate + Calcium Carbonate + Vitamin C + Vitamin D3
Type	Effervescent Tablet
Therapeutic Class	Specific mineral & vitamin combined preparations
Manufacturer	Kumudini Pharma Ltd
Available Country	Bangladesh
Last Updated:	September 19, 2023 at 7:00 am

Uses

This combination is used for-

As an adjunct to specific therapy for osteoporosis
Increased demand for Calcium, Vitamin-C and Vitamin-D such as pregnancy, lactation, period of rapid growing (in childhood, addoloscence) and in old age
In osteomalacia
The prevention and treatment of Calcium deficiency/ Vitamin-D deficiency especially in the housebound and hospitalized elderly subjects
As adjuvant in cold and influenza
Postmenopausal syndromes
Premenstrual symptoms
In high body temperatures
As alkalizing agent in conditions with systemic acidosis.

Efercal is also used to associated treatment for these conditions: Acid Reflux, Acid indigestion, Bloating, Calcium Deficiency, Calcium Metabolism Disorders, Calcium and Vitamin D Deficiencies, Colic, Dyspepsia, Gastric Ulcer, Gastroesophageal Reflux, Heartburn, Hemorrhoids, Hot Flushes, Hyperacidity, Hyperphosphataemia, Hypovitaminosis D, Low Bone Density, Osteodystrophy, Osteomalacia, Osteoporosis, Postmenopausal Osteoporosis, Postoperative Gas, Proctitis, Vertebral Fractures, Calcium loss, Gastrointestinal ulceration, Dietary supplementationCalcium Deficiency, Hypovitaminosis D, Osteomalacia, Osteoporosis, Calcium supplementation

How Efercal works

Calcium carbonate is a basic inorganic salt that acts by neutralizing hydrochloric acid in gastric secretions. It also inhibits the action of pepsin by increasing the pH and via adsorption. Cytoprotective effects may occur through increases in bicarbonate ion (HCO₃^-) and prostaglandins. Neutralization of hydrochloric acid results in the formation of calcium chloride, carbon dioxide and water. Approximately 90% of calcium chloride is converted to insoluble calcium salts (e.g. calcium carbonate and calcium phosphate).

Dosage

Efercal dosage

Adults and children of school age: 1 effervescent tablet daily

Children 3 to 7 years: ½ effervescent tablet daily

Infants: As prescribed by the physician

Dissolve one tablet in half glass (100 ml) of water.

Side Effects

The use of Calcium supplements has rarely given rise to mild gastrointestinal disturbances, such as constipation, flatulence, nausea, gastric pain and diarrhoea. Following administration of Vitamin-D supplements occasional skin rash has been reported. Hypercalciuria, and in rare cases hypercalcaemia have been seen in long-term treatment with Vitamin-D at high doses.

Precaution

Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. Periodic checks of plasma Calcium levels and urinary Calcium excretion should be made in patients with mild to moderate renal failure or mild hypercalciuria. In patients with a history of renal stones urinary Calcium excretion should be measured to exclude hypercalciuria. With long-term treatment it is advisable to monitor serum and urinary Calcium levels and kidney function, and reduce or stop treatment temporarily if urinary Calcium exceeds 7.5 mmol/24 hours. Allowances should be made for Calcium and Vitamin-D supplements from other sources.

Interaction

The risk of hypercalcemia should be considered in patients taking thiazide diuretics since these drugs can reduce urinary calcium excretion. Hypercalcemia must be avoided in digitalised patients. Certain foods (e.g. those containing oxalic acid, phosphate or phytinic acid) may reduce the absorption of calcium. Concomitant therapy with phenytoin or barbiturates can decrease the effect of vitamin-D because of metabolic activation. The effect of digitalis and other cardiac glycosides may be accentuated with the oral administration of calcium combined with vitamin-D. Calcium salts may reduce the absorption of thyroxine, bisphosphonates, sodium fluoride, quinolone or tetracycline antibiotics or iron. It is advisable to allow a minimum period of 4 hours before taking thecalcium.

Volume of Distribution

Calcium is rapidly distributed taken up by skeletal tissues following absorption and distribution into extracellular fluids. Bone contains 99% of the body's calcium and the remaining 1% is approximately equally distributed between intracellular and extracellular fluids.

Elimination Route

Maximal absorption occurs at doses of 500 mg or less taken with food. Oral bioavailability depends on intestinal pH, the presence of food and dosage.

Elimination Route

Excreted mainly in the feces. The majority of renally filtered calcium is reabsorbed in the ascending limb of the loop of Henle and the proximal and distal convoluted tubules. Also secreted by sweat glands.

Pregnancy & Breastfeeding use

During pregnancy and lactation treatment with this supplements should always be under the direction of a physician.

During pregnancy and lactation, requirements for calcium and vitamin-D are increased but in deciding on the required supplementation allowances should be made for availability of these agents from other sources.

Overdoses of vitamin-D have shown teratogenic effects in pregnant animals. Vitamin-D and its metabolites pass into the breast milk.

Contraindication

Absolute contraindications are hypercalcaemia resulting from myeloma, bone metastases or other malignant bone disease, sarcoidosis; primary hyperparathyroidism and Vitamin-D overdosage. It is also contraindicated in severe renal failure and hypersensitivity to any of the tablet ingredients.

Special Warning

USE IN CHILDREN: Calcium carbonate has been extensively studied in children and infants with chronic renal failure and is both safe and effective.

USE IN ELDERLY: In case of elderly patients with renal failure when calcium carbonate is taken constipation may be troublesome one for this group. For this reason, monitoring of serum calcium and phosphate is of course indicated for elderly patients.

Acute Overdose

The most serious consequence of acute or chronic overdose is hypercalcaemia due to Vitamin-D toxicity. Symptoms include nausea, vomiting, polyuria, and constipation. Chronic overdoses can lead to vascular and organ calcification as a result of hypercalcaemia. Treatment should consist of stopping all intakes of calcium and Vitamin-D and rehydration.