Calcium + Vitamin D3 + Vitamin C + Vitamin E + Multimineral

Approved & Common Clinical Uses:

• Osteoporosis & Osteopenia: For prevention and adjunctive treatment of age-related, postmenopausal, or corticosteroid-induced bone loss.
• Calcium & Vitamin D Deficiency: In patients with inadequate dietary intake or increased physiological demand (e.g., pregnancy, adolescence, elderly).
• General Nutritional Support: Multivitamin and mineral supplementation in patients with poor diet, malabsorption, or chronic illnesses.
• Fracture Healing: Enhances bone regeneration and mineralization after orthopedic injury or surgery.
• Immune System Support: Especially in individuals prone to infections, Vitamin C and E contribute antioxidant and immune-regulatory roles.
• Chronic Fatigue or Debility: As part of multinutrient therapy in convalescent or debilitated patients.

Adults:

• Typical dose: 1 tablet once or twice daily (dose may vary based on product formulation).
• Best taken with food to enhance absorption and reduce gastric irritation.

Pediatric Use:

• Only formulations approved for pediatric use should be administered.
• Dosage is weight and age-dependent (e.g., chewable tablets or syrups).
• Pediatrician guidance required for dosing under 12 years.

Elderly:

• No specific dose adjustment, but monitor calcium levels and renal function.
• Increased vitamin D requirement is common in elderly patients.

Pregnant & Lactating Women:

• Safe in recommended daily amounts. Dosing individualized based on dietary intake and prenatal needs.

Renal/Hepatic Impairment:

• Caution in renal insufficiency due to risk of hypercalcemia and mineral imbalance.
• Monitor serum calcium, phosphate, and vitamin D levels regularly.

Route of Administration:

• Oral, with water, preferably after meals.

Duration:

• Based on clinical need; can be used for short-term replenishment or long-term maintenance.

This combination works synergistically to support bone health, immune function, and antioxidant defense. Calcium serves as a vital component in bone mineralization and muscular function. Vitamin D3 (Cholecalciferol) enhances intestinal absorption of calcium and phosphate, facilitating bone growth and remodeling. Vitamin C (Ascorbic Acid) supports collagen synthesis and boosts immunity. Vitamin E (Tocopherol) acts as a lipid-soluble antioxidant, protecting cells from oxidative stress. Multiminerals such as magnesium, zinc, selenium, copper, and manganese participate in enzymatic functions, bone metabolism, antioxidant defense, and tissue repair.

• Calcium: Absorption is ~20–30%, enhanced by vitamin D. Stored mainly in bones. Excreted via urine and feces.
• Vitamin D3: Absorbed in the small intestine (fat-soluble), metabolized in the liver to 25(OH)D and then in the kidneys to active 1,25(OH)₂D₃. Half-life: ~15–20 days.
• Vitamin C: Rapidly absorbed in the small intestine. Distributed widely in tissues. Metabolized in liver; excreted renally. Half-life: ~8–40 days (dose-dependent).
• Vitamin E: Absorbed with dietary fat, transported via chylomicrons. Stored in adipose tissue. Excreted in bile and urine. Long half-life (~48–60 hours).
• Minerals: Each has distinct absorption and excretion profiles—often affected by dietary factors, interactions, and individual bioavailability.

• Pregnancy: All components are considered safe in recommended dietary allowances (RDA). Calcium and vitamin D are often supplemented during pregnancy to support fetal bone growth.
• Lactation: Compatible with breastfeeding. Small amounts of vitamins and minerals are excreted in breast milk but are not harmful at physiological doses.
• Caution: High doses may lead to hypercalcemia or vitamin D toxicity.

• Calcium Supplement with Vitamins and Minerals
• Subclasses:
• Bone Health Supplement
• Antioxidant & Immune Support
• Multivitamin-Multimineral Complex

• Hypersensitivity to any component of the formulation
• Hypercalcemia (e.g., due to hyperparathyroidism, vitamin D overdose)
• Severe renal impairment or renal stones (nephrolithiasis)
• Hypervitaminosis D
• Hemochromatosis or other mineral overload disorders

• Monitor serum calcium, phosphate, and vitamin D in patients on long-term therapy.
• Use cautiously in patients with renal impairment, sarcoidosis, or malabsorption syndromes.
• Avoid excessive supplementation from multiple sources to prevent hypervitaminosis.
• Risk of kidney stones with high calcium or vitamin C intake.
• May interfere with absorption of certain drugs (e.g., bisphosphonates, tetracyclines).

Common (≥1%):

• Gastrointestinal: Nausea, bloating, constipation, flatulence, metallic taste
• Musculoskeletal: Mild bone or muscle pain (initially)
• Skin: Mild rash (hypersensitivity)

Less Common:

• Hypercalcemia: Confusion, fatigue, arrhythmia, muscle weakness
• Hypervitaminosis D: Nausea, vomiting, polyuria, kidney dysfunction

Rare:

• Allergic reactions: Anaphylaxis, urticaria
• Renal calculi (with chronic high-dose calcium)

• Tetracyclines/Quinolones: Reduced absorption when taken with calcium—separate by ≥2 hours.
• Thiazide Diuretics: Increased risk of hypercalcemia.
• Iron & Zinc Supplements: Competitive absorption—space doses.
• Corticosteroids: May impair calcium absorption.
• Digitalis Glycosides (e.g., digoxin): Hypercalcemia can potentiate toxicity.
• Antacids with aluminum/magnesium: May alter mineral absorption.

Enzyme Involvement: No significant CYP450-mediated interactions.

• Recent guideline updates from WHO and global nutrition authorities emphasize combination calcium and vitamin D as key in osteoporosis prevention, especially in postmenopausal women and elderly men.
• Multivitamin-multimineral preparations continue to be recommended for individuals at nutritional risk, including those with chronic illness, aging population, or malabsorption.
• No recent FDA safety warnings for this combination in standard OTC formulations.

• Store below 25°C (77°F), in a cool and dry place.
• Protect from light and excessive moisture.
• Keep tightly closed in original container.
• Do not freeze.
• Keep out of reach of children.
• For effervescent or chewable tablets: use immediately after opening blister or foil.