Calvin Plus

Calcium, cholecalciferol and minerals.

Dietary supplement.
Calvin Plus contains calcium which provides more calcium for bones. Calvin Plus also contains nutrients for bones. Calvin plus can be given as adjuncts to prevent osteoporosis.

Take 1-2 tablets once a day. Max of 2,000 mg. The doses should be divided by taking in the morning and at night or as directed by physician. In patients with renal failure, dosage has to be adapted according to the creatinine clearance.

Signs, Symptoms and Treatment of Overdose: Overdose can lead to hypercalcaemia. Symptoms of hypercalcaemia may include anorexia, intense thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental disturbance, polydipsia, polyuria, bone pain, nephrocalcinosis, nephrolithiasis, dehydration and hypertension. Severe hypercalcaemia may result in cardiac arrhythmias, coma and death.
The treatment should be aimed at lowering serum calcium levels. Treatment of hypercalcaemia: The treatment with calcium must be stopped. Treatment with thiazide diuretics, lithium, cardiac glycoside and vitamin A must also be discontinued. Rehydration and according to severity of the intoxication, isolated or combined use of loop diuretics, bisphosphonates, calcitonin and corticosteroids.
Overdose can also lead to copper toxicity in patient with Wilson's disease. Symptoms may include epigastric pain, anorexia, nausea, vomiting, diarrhea, hepatic toxicity, jaundice, hypotension, metallic taste, convulsion and coma.
Treatment: discontinue and symptomatic therapy.

Conditions associated with hypercalcaemia, hypercalciuria.
Renal impairment (Chronic).
Renal stones or history of renal stones.
Renal osteodystrophy with hyperphosphataemia.
Wilson's disease; hepatic and biliary, disease (copper).
Hypersensitivity of any components of tablet.

Patients with renal failure or mild hypercalciuria should be supervised carefully and the plasma and urinary calcium levels should be monitored regularly.
In case of long term treatment, the urinary calcium excretion must be monitored and reduce or stop treatment temporarily if urinary calcium exceeds 7.5-9 mmol/24 hours.
Daily dose of calcium should not above 2000 mg.
Daily dose of Vitamin D3 should not above 400 units (10μg).

Following events have been reported: Metabolism and nutrition disorders: Hypercalcemia and hypercalciuria.
Gastrointestinal disorders: Constipation, flatulence, nausea, abdominal pain, vomiting and diarrhea.
Skin and subcutaneous disorders: Pruritus, rash and urticaria.

Interactions with Other Medicaments: Concomitant with the other medicaments following may cause the drug interaction: Cardiac glycosides: The inotropic and toxic effects of cardiac glycosides, calcium and vitamin D are synergistic and arrhythmias may occur if these drugs are given together. Monitoring of ECG and serum calcium levels is recommended.
Tetracyclines, thyroxine, bisphosphonates, sodium fluoride, quinolone and iron: may reduce absorption of these drugs. It is recommended that administration separately by at least 3 hours.
Thiazide diuretics: The risk of hypercalcaemia should be considered because it reduce the urinary calcium excretion and increase renal excretion of magnesium.
Systemic corticosteroids: These drugs reduce calcium absorption so that the dose of calcium may be increased.
Alcohol: may reduce calcium and magnesium absorption.
Antacid containing aluminium and laxatives: may reduce calcium absorption.
Anticonvulsant: may reduce serum calcium level and reduce effect of vitamin D by accelerating its metabolism.
Penicillamine and trientine: reduce absorption of copper, zinc and vice versa: give 2 hrs apart.
Oral contraceptive: reduce plasma zinc levels.
Cholestyramine, colestipol, liquid paraffin and sucralfate: reduce intestinal absorption of vitamin D.

Calcium/with Vitamins

A12AX - Calcium, combinations with vitamin D and/or other drugs ; Used as dietary supplements.

Non-Rx