Calcium gluconate tablets 500 mg blister 10 pcs.

Active ingredient: calcium gluconate.

1 tablet contains calcium gluconate in terms of 100% substance – 500 mg;

excipients: potato starch, croscarmellose sodium, talc, calcium stearate.

Pills.

Main physicochemical properties: white, flat-cylindrical tablets, with a score and a bevel.

Calcium preparations. Atx code A12A A03.

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, myocardial function, 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 in many pathological processes; severe hypocalcemia contributes to the occurrence of tetany. Calcium gluconate, in addition to eliminating hypocalcemia, reduces vascular permeability, exhibits anti-allergic, anti-inflammatory, hemostatic effects, and also reduces exudation. Calcium ions are a plastic material for the skeleton and teeth, participate in various enzymatic processes, regulate the speed of nerve impulse conduction and the permeability of cell membranes. Calcium ions are necessary for the process of neuromuscular transmission, to maintain the contractile function of the myocardium. Unlike calcium chloride, calcium gluconate has a weaker local irritant effect.

Pharmacokinetics.

When taken orally, calcium gluconate 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 and into breast milk. Excreted from the body with urine and feces.

Diseases accompanied by hypocalcemia, increased permeability of cell membranes, impaired conduction of nerve impulses in muscle tissue. hypoparathyroidism (latent tetany, osteoporosis), impaired vitamin D metabolism (rickets, spasmophilia, osteomalacia), hyperphosphatemia in patients with chronic renal failure. increased need for calcium (period of intensive growth in children and adolescents, pregnancy, breastfeeding), insufficient Ca2 + content in food, impaired metabolism in the postmenopausal period, bone fractures. increased excretion of Ca2 + (prolonged bed rest, chronic diarrhea, hypocalcemia with prolonged use of diuretics, antiepileptic drugs, glucocorticosteroids). in complex therapy: bleeding of various etiologies, allergic diseases (serum sickness, urticaria, febrile syndrome, pruritic dermatoses, angioedema); bronchial asthma, dystrophic alimentary edema, pulmonary tuberculosis, eclampsia, parenchymal hepatitis, toxic liver lesions, nephritis. poisoning with 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).

Hypersensitivity to the components of the drug, hypercalcemia, severe hypercalciuria, hypercoagulation (increased blood clotting), tendency to thrombosis, severe atherosclerosis, nephrourolithiasis (calcium), severe renal failure, sarcoidosis, taking digitalis preparations.

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 intake should be at least 3 hours). Calcium gluconate reduces the bioavailability of phenytoin. When taken simultaneously with vitamin D or its derivatives, calcium absorption increases. Cholesterolamine reduces the absorption of calcium in the digestive tract. When the drug is used together with cardiac glycosides, the cardiotoxic effect of the latter is enhanced. Glucocorticosteroids reduce the absorption of calcium. When combined with thiazide diuretics, the risk of developing hypercalcemia increases. The drug may reduce the effect of calcitonin in hypercalcemia, the bioavailability of phenytoin, the effect of calcium channel blockers. When used simultaneously with quinidine, a slowdown in intraventricular conduction and increased toxicity of quinidine are possible.

Forms insoluble or sparingly soluble calcium salts with carbonates, salicylates, and sulfates.

Some foods (spinach, rhubarb, bran, grains) can reduce calcium absorption from the gastrointestinal tract.

When used in patients receiving 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 discontinued. Due to the fact that vitamin D3 increases the absorption of calcium from the gastrointestinal tract, in order to avoid calcium overdose, it is necessary to take into account the intake of vitamin D3 and calcium from other sources.

Patients with mild hypercalciuria (more than 300 mg/day = 7.5 mmol/day), mild renal impairment, and a history of urolithiasis should be prescribed calcium gluconate with caution and the urinary calcium excretion should be monitored regularly. If necessary, the dose of the drug should be reduced or discontinued. Patients with a tendency to urinary calculi are recommended to increase the amount of fluid consumed during treatment.

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.

The use of the drug is permissible taking into account the benefit to the woman / risk to the fetus (child), which is determined by the doctor. When using calcium preparations during breastfeeding, it is possible for it to penetrate into breast milk.

The drug does not affect the reaction speed when driving vehicles and working with complex mechanisms.

It is prescribed orally before meals. The tablet must be chewed or crushed.

Adults and children over 14 years of age are prescribed the drug in a single dose of 1-3 g (2-6 tablets), children from 3 to 4 years old – 1 g (2 tablets), from 5 to 6 years old – 1-1.5 g (2-3 tablets), from 7 to 9 years old – 1.5-2 g (3-4 tablets), from 10 to 14 years old – 2-3 g (4-6 tablets) 2-3 times a day. The daily dose for elderly patients should not exceed 2 g (4 tablets) per day.

The duration of treatment is determined by the doctor individually, depending on the patient’s condition.

The drug is used in children aged 3 years and older.

With prolonged use in high doses, hypercalcemia with deposition of calcium salts in the body is possible, dyspeptic phenomena are possible. The likelihood 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, muscle pain, joint pain, arterial hypertension.

Treatment: drug withdrawal; in severe cases – parenteral calcitonin at a dose of 5-10 IU / kg body weight per day (diluted in 500 ml of sterile physiological sodium chloride solution, intravenously drip for 6 hours. Intravenous jet slow administration 2-4 times a day is possible).

The drug is usually well tolerated, but sometimes there may be violations:

from the digestive tract: nausea, vomiting, diarrhea, pain in the epigastric region, constipation; with prolonged use in high doses – the formation of calcium stones in the intestines;

Cardiovascular system: bradycardia;

Metabolic: hypercalcemia, hypercalciuria;

From the urinary system: impaired renal function (frequent urination, swelling of the lower extremities).

Allergic reactions are possible.

These phenomena quickly disappear after reducing the dose or discontinuing the drug.

8 years.

Store in the original packaging at a temperature not exceeding 25 ºС.

Keep out of reach of children.