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CALCIUM GLUCONATE
Release form
Tablets
For children
Older 3 years
For pregnant women
For a doctor's recommendation
For nursing mothers
For a doctor's recommendation
For drivers
Does not affect
Storage temperature
to 25 °C
INSTRUCTION
storage
active ingredient: calcium gluconate; calcium salt of gluconic acid; 1 tablet contains calcium gluconate 0.5 g; excipients: calcium stearate, potato starch, sodium bicarbonate.
Medicinal form
Tablets. The main physical and chemical properties: white tablets with a matte shade, a flat surface, a line and a chamfer.
Pharmacotherapeutic group
Calcium preparations. ATX code A12A A03.
Pharmacological properties
Pharmacodynamics. Calcium gluconate is a calcium salt of gluconic acid containing 9% calcium. Calcium ions are involved in the transmission of nerve impulses, contraction of smooth and skeletal muscles, functioning of the myocardium, blood clotting processes; they are necessary for the formation of bone tissue, normal functioning of other systems and organs. The concentration of calcium ions in the blood decreases with many pathological processes; pronounced hypocalcemia contributes to the occurrence of tetany. Calcium gluconate, in addition to eliminating hypocalcemia, reduces the permeability of blood vessels, has an anti-allergic, anti-inflammatory, hemostatic effect, and also reduces exudation. Calcium ions are a plastic material for the skeleton and teeth, they participate in various enzymatic processes, regulate the speed of nerve impulses and the permeability of cell membranes. Calcium ions are necessary for the process of neuromuscular transmission, to support the contractile function of the myocardium. Unlike calcium chloride, calcium gluconate has a weaker local irritant effect. Pharmacokinetics. When calcium gluconate is taken internally, it is partially absorbed, mainly in the small intestine. The maximum concentration in blood plasma is reached after 1.2–1.3 hours. The half-life of ionized calcium from blood plasma is 6.8–7.2 hours. Penetrates through the placental barrier, penetrates into breast milk. Excreted from the body with urine and feces.
Indication
Diseases accompanied by hypocalcemia, increased permeability of cell membranes, impaired conduction of nerve impulses in muscle tissue. Hypoparathyroidism (latent tetany, osteoporosis), vitamin D metabolism disorders (rickets, spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure. Increased need for calcium (period of intensive growth of children and adolescents, pregnancy, period of breastfeeding), insufficient content of Ca2+ in food, disturbance of its metabolism in the postmenopausal period, bone fractures. Increased excretion of Ca2+ (prolonged bed rest, chronic diarrhea, hypocalcemia with long-term use of diuretics, antiepileptic drugs, glucocorticosteroids). In complex therapy: bleeding of various etiologies, allergic diseases (serum disease, urticaria, gaping syndrome, pruritic dermatoses, angioedema); bronchial asthma, dystrophic alimentary edema, pulmonary tuberculosis, eclampsia, parenchymal hepatitis, toxic liver damage, nephritis. Poisoning by magnesium salts, oxalic acid, soluble salts of hydrofluoric acid (when interacting with calcium gluconate, insoluble and non-toxic calcium oxalate and calcium fluoride are formed).
Contraindication
• Hypersensitivity to the components of the medicinal product. • Hypercalcemia. • Pronounced hypercalciuria. • Hypercoagulation. • Tendency to blood clot formation. • Pronounced atherosclerosis. • Nephrourolithiasis (calcium). • Severe renal failure. • Sarcoidosis. • Taking digitalis drugs. Special security measures. When used in patients who receive cardiac glycosides and/or diuretics, as well as during long-term treatment, the concentration of calcium and creatinine in the blood should be monitored. In case of an increase in their concentration, the dose of the drug should be reduced or its use should be temporarily stopped. Due to the fact that vitamin D3 increases the absorption of calcium from the digestive tract, in order to avoid an overdose of calcium, it is necessary to take into account the intake of vitamin D3 and calcium from other sources. With caution and with regular monitoring of the level of calcium excretion with urine, it is prescribed to patients with moderate hypercalciuria, which exceeds 300 mg/day (7.5 mmol/day), mildly expressed disorders of kidney function, and urolithiasis in the anamnesis. If necessary, the dose of the drug should be reduced or discontinued. Patients with a tendency to the formation of calculi in the urinary tract during treatment are recommended to increase the volume of fluid consumed. During treatment with the drug, high doses of vitamin D or its derivatives should be avoided, unless there are special indications for this. An interval of at least 3 hours should be observed between taking "Calcium gluconate" tablets and oral preparations of estramustine, etidronate and other bisphosphonates, phenytoin, quinolones, tetracycline antibiotics, oral iron preparations and fluoride preparations.
Interaction with other medicinal products and other forms of interaction
The drug slows down the absorption of estramustine, etidronate and other bisphosphonates, quinolones, tetracycline antibiotics, oral iron preparations and fluoride preparations (the interval between their administration should be at least 3 hours). The drug slows down the absorption of phenytoin. Glucocorticosteroids reduce the absorption of calcium in the digestive tract. When taken simultaneously with vitamin D or its derivatives, absorption of calcium increases. Cholesterolamine reduces the absorption of calcium in the digestive tract. With simultaneous use of the drug with cardiac glycosides, the cardiotoxic effects of the latter are enhanced. When combined with thiazide diuretics, the risk of hypercalcemia increases. The drug can reduce the effect of calcitonin in hypercalcemia, the bioavailability of phenytoin, the effect of calcium channel blockers. With simultaneous use with quinidine, it is possible to slow down the intraventricular conduction and increase the toxicity of quinidine. Forms insoluble or sparingly soluble calcium salts with carbonates, salicylates, sulfates. The absorption of calcium from the gastrointestinal tract can be reduced by some foods (spinach, rhubarb, bran, grains).
Features of use
Use during pregnancy or breastfeeding. The use of the medicinal product is permissible taking into account the ratio of benefit for the woman and risk for the fetus (child), which is determined by the doctor. When taking calcium preparations during breastfeeding, it may be excreted in breast milk. The ability to influence the speed of reaction when driving vehicles or other mechanisms. The drug does not affect the ability to drive vehicles and mechanisms.
Methods of application
Calcium gluconate should be used internally before meals in a single dose: adults and children over 14 years old – 1–3 g (2–6 tablets), children aged 3 to 4 years – 1 g (2 tablets), 5 to 6 years old – 1–1.5 g each (2–3 tablets), from 7 to 9 years old – 1.5–2 g each (3–4 tablets), from 10 to 14 years old – 2–3 g each (4–6 tablets ) 2–3 times a day. The daily dose for the elderly should not exceed 2 g (4 tablets). The duration of treatment is determined by the doctor individually, depending on the patient's condition. The tablet must be chewed or crushed. Children. There is no experience of using the drug in children under 3 years of age.
Overdose
With long-term use in high doses, hypercalcemia with deposition of calcium salts in the body is possible, and dyspeptic phenomena are possible. The probability of developing hypercalcemia increases with simultaneous treatment with high doses of vitamin D or its derivatives. Symptoms of hypercalcemia: drowsiness, weakness, anorexia, abdominal pain, vomiting, nausea, constipation, polydipsia, polyuria, increased fatigue, irritability, malaise, depression, dehydration, possible heart rhythm disturbances, myalgia, arthralgia, arterial hypertension. Treatment: withdrawal of the drug; in severe cases – parenteral administration of calcitonin at a dose of 5–10 IU/kg of body weight per day (diluted in 500 ml of sterile physiological sodium chloride solution, administered intravenously as a drip over 6 hours. Intravenous slow administration is possible 2–4 times a day).
Side effects
The drug is usually well tolerated, but sometimes disturbances are possible: from the side of the cardiovascular system: bradycardia; from the side of metabolism: hypercalcemia, hypercalciuria; from the side of the digestive tract: nausea, vomiting, diarrhea, pain in the epigastric region, constipation; with long-term use in high doses - the formation of calcium concretions in the intestines; from the urinary system: impaired kidney function (increased urination, swelling of the lower extremities). Sometimes allergic reactions may occur. These phenomena quickly disappear after reducing the dose or canceling the drug.
Expiration date
5 years.
Storage conditions
Store in the original packaging at a temperature not higher than 25 ºС. Keep out of the reach of children.
Packaging
10 tablets in strips or blisters.
Leave category
Without a prescription.
Producer
Monfarm PJSC.
Address
Ukraine, 19161, Cherkasy region, Uman district, village Avramivka, str. Zavodska, 8.