Gafercal Plus

Gafercal Plus 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

Ferrous ascorbate, a synthetic molecule of ascorbic acid and iron.

Ferrous Ascorbate when administered is converted to ferric form and immediately is reduced to the ferrous form into the stomach. This reduced ferrous form is then transferred to the duodenum where it is highly absorbed. Ferrous Ascorbate has the advantage of providing both ferrous ion and ascorbate in the same compound. There is no dissociation on entering GI Tract due to the stable chelate of iron with ascorbate. Folic Acid itself is biochemically inactive, is converted to tetrahydrofolic acid and methyltetrahydrofolate by dihydrofolate reductase in liver. These folic acid congeners are transported across cells by receptor-mediated endocytosis where they are needed to maintain numerous body functions.

The major activity of supplemental iron is in the prevention and treatment of iron deficiency anemia. Iron has putative immune-enhancing, anticarcinogenic and cognition-enhancing activities.

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.

Gafercal Plus
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	Gafercal Plus
Generic	Ferrous Ascorbate + Vitamin D3 / Cholecalciferol + Mecobalamin + Calcium Citrate + Vitamin B9 / Folic Acid / Folate + Zinc Sulphate
Weight	100mg
Type	Tablet
Therapeutic Class
Manufacturer	Gates Pvt Ltd
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.

Indicated in the treatment of iron deficiency anemia.

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

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

How Gafercal Plus 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.

Iron is necessary for the production of hemoglobin. Iron-deficiency can lead to decreased production of hemoglobin and a microcytic, hypochromic anemia.

Dosage

Gafercal Plus dosage

Adult & Elderly: One tablet (33 mg) a day before or after meal (food independent absorption) or as directed by the physician. In more severe cases, two tablets a day may be required as prescribed by the physician. Safety and effectiveness in pediatric patients have not been established.

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

The treatment of a neurotic patient was interrupted because of nausea and regurgitation. In pregnant women, the incidence of pyrosis and chronic constipation is slightly increased.

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 .

Acute iron overdosage can be divided into four stages. In the first stage, which occurs up to six hours after ingestion, the principal symptoms are vomiting and diarrhea. Other symptoms include hypotension, tachycardia and CNS depression ranging from lethargy to coma. The second phase may occur at 6-24 hours after ingestion and is characterized by a temporary remission. In the third phase, gastrointestinal symptoms recur accompanied by shock, metabolic acidosis, coma, hepatic necrosis and jaundice, hypoglycemia, renal failure and pulmonary edema. The fourth phase may occur several weeks after ingestion and is characterized by gastrointestinal obstruction and liver damage. In a young child, 75 milligrams per kilogram is considered extremely dangerous. A dose of 30 milligrams per kilogram can lead to symptoms of toxicity. Estimates of a lethal dosage range from 180 milligrams per kilogram and upwards. A peak serum iron concentration of five micrograms or more per ml is associated with moderate to severe poisoning in many.

Precaution

Oral iron preparations may aggravate existing peptic ulcer, regional enteritis and ulcerative colitis. Iron compounds taken orally can impair the absorption of tetracycline antibiotics. Antacids given concomitantly with iron compounds decrease iron absorption.

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 .

The efficiency of absorption depends on the salt form, the amount administered, the dosing regimen and the size of iron stores. Subjects with normal iron stores absorb 10% to 35% of an iron dose. Those who are iron deficient may absorb up to 95% of an iron dose.