Calbo-C

• Calcium Deficiency: Treatment and prevention of calcium deficiency arising from dietary insufficiency, malabsorption, or increased physiological demand.
• Osteoporosis: Adjunct therapy for prevention and management of osteoporosis to enhance bone mineral density.
• Rickets and Osteomalacia: Management of vitamin D and calcium deficiency-related bone disorders.
• Hypocalcemia: Correction of low serum calcium levels due to hypoparathyroidism or other causes.
• Vitamin C Deficiency: Prevention and treatment of scurvy and to support immune function.
• Postmenopausal Bone Health: Supplementation to reduce risk of fractures.
• Supporting Wound Healing: Vitamin C enhances collagen synthesis aiding tissue repair.
• Off-label Uses:
• General supplementation during pregnancy and lactation.
• Adjunct in bone metabolic disorders requiring calcium and antioxidant support.

Adults:

• Typical dose provides approximately 500–1000 mg elemental calcium daily (from calcium lactate gluconate and calcium carbonate combined) plus 60–100 mg vitamin C per day.
• Usually administered orally in divided doses with meals to maximize absorption and reduce gastrointestinal discomfort.
• Dose adjustment based on serum calcium levels, dietary intake, and clinical response.

Pediatrics:

• Use under specialist supervision; dose based on weight and clinical need.

Elderly:

• Standard adult dosing recommended; monitor calcium and renal function regularly.

Special Populations:

• Renal Impairment: Use with caution; monitor serum calcium and vitamin C status.

Route of Administration:

• Oral tablets or effervescent formulations.

Duration:

• Long-term use as prescribed; periodic monitoring advised.

• Calcium Lactate Gluconate and Calcium Carbonate: Both compounds dissociate in the gastrointestinal tract releasing elemental calcium, essential for physiological processes such as bone mineralization, muscle contraction, nerve transmission, and blood coagulation. Calcium supplementation corrects hypocalcemia and supports skeletal health by maintaining adequate serum calcium concentrations.
• Vitamin C (Ascorbic Acid): A potent antioxidant that supports collagen synthesis, enhances immune function, and improves iron absorption. It facilitates bone matrix formation and aids in wound healing, complementing calcium’s role in skeletal integrity.

Together, this combination optimizes calcium bioavailability and supports bone health and overall physiological functions requiring calcium and vitamin C.

• Calcium Lactate Gluconate and Calcium Carbonate:
• Calcium is absorbed primarily in the small intestine; bioavailability varies but calcium citrate and lactate salts are better absorbed than carbonate in patients with reduced gastric acid.
• Calcium is distributed mainly in extracellular fluid and stored in bone.
• Excess calcium is eliminated via renal excretion.
• Vitamin C:
• Rapidly absorbed from the gastrointestinal tract via active transport mechanisms.
• Peak plasma levels occur within 2–3 hours after oral administration.
• Metabolized to dehydroascorbic acid and further metabolites.
• Excreted in urine.

• Pregnancy: Category C (for calcium salts and vitamin C). Calcium and vitamin C are essential nutrients during pregnancy; supplementation is considered safe when used as recommended.
• Lactation: Both calcium and vitamin C are excreted in breast milk in small amounts and are generally safe during breastfeeding.

• Therapeutic Class: Mineral Supplement + Vitamin
• Subclass: Calcium salts combined with Vitamin C (ascorbic acid)

• Known hypersensitivity to any component of the formulation.
• Hypercalcemia or hypercalciuria.
• History of calcium-containing kidney stones.
• Severe renal impairment without medical supervision.
• Vitamin C hypersensitivity or history of oxalate kidney stones related to high-dose vitamin C.

• Monitor serum calcium and renal function in patients with renal impairment or predisposition to nephrolithiasis.
• Excessive calcium intake may lead to hypercalcemia and related complications.
• High doses of vitamin C may cause gastrointestinal discomfort and increase risk of oxalate stone formation.
• Use cautiously in patients on digoxin or thiazide diuretics.
• Advise patients to maintain adequate hydration.

Common:

• Gastrointestinal upset: nausea, constipation, abdominal discomfort, diarrhea (mainly with vitamin C).
• Metallic taste.

Serious/Rare:

• Hypercalcemia symptoms: weakness, confusion, polyuria.
• Allergic reactions: rash, itching, swelling (rare).
• Oxalate kidney stones with excessive vitamin C intake.

• Tetracyclines and Fluoroquinolones: Calcium reduces their absorption; separate dosing by 2–4 hours.
• Bisphosphonates: Calcium may reduce absorption; stagger administration times.
• Digitalis Glycosides: Hypercalcemia increases risk of digoxin toxicity.
• Thiazide Diuretics: May increase risk of hypercalcemia.
• Iron Supplements: Vitamin C enhances iron absorption but calcium may reduce it; dosing separation may be needed.
• Warfarin: Vitamin C in large doses may alter anticoagulant effects.

• Recent guidelines reaffirm calcium plus vitamin C supplementation for osteoporosis prevention in at-risk populations.
• Recommendations emphasize adequate hydration to reduce risk of kidney stones with vitamin C.
• No significant changes in dosing or indications; ongoing monitoring for hypercalcemia advised.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture and light.
• Keep container tightly closed.
• Keep out of reach of children.