Reef-D Vita Tablet

✔️ Composition

Each tablet contains:

• Calcium Carbonate (Coral Source): 1250 mg, providing 500 mg of elemental calcium.
• Vitamin D (Cholecalciferol): 200 IU.

For a higher dose, the DX tablet contains:

• Calcium Carbonate: 1500 mg (providing 600 mg of elemental calcium).
• Vitamin D: 400 IU.

Additionally, effervescent tablets also contain Calcium Carbonate (Coral source) 1500 mg (600 mg of elemental calcium), and Vitamin D3 400 IU.

✔️ Overdose may lead to hypervitaminosis D and hypercalcemia, with symptoms like:

• Nausea, vomiting, constipation, and abdominal pain.
• Muscle weakness, fatigue, mental disturbances.
• Severe cases may cause kidney damage, arrhythmias, and even coma.

In cases of overdose, immediate discontinuation of calcium and vitamin D supplements is necessary. Treatments include rehydration, discontinuing certain medications, and possibly using diuretics, bisphosphonates, calcitonin, or corticosteroids, depending on the severity of symptoms.

✔️ Side Effects

• Gastrointestinal Irritation: Calcium Carbonate may cause GI irritation or constipation.
• Hypercalcemia: Rare, but can occur with excessive doses, especially in people with chronic renal failure.
• Allergic Reactions: Skin rash, irregular heartbeats, nausea, dry mouth, drowsiness.
• Vitamin D Side Effects: Rashes may appear due to vitamin D supplements.

✔️ Dosage & Administration

• Regular Tablets: Take one tablet once or twice daily with plenty of water, preferably after meals for better absorption.
• Effervescent Tablets: Dissolve 1 effervescent tablet in a glass of water, stir, and drink. Taking it with food ensures better absorption.

The dosage should be followed as per a physician’s guidance.

✔️ Drug Interactions

• Thiazide Diuretics: Reduce calcium excretion in urine, so it increases the risk of hypercalcemia. Regular monitoring of serum calcium is necessary when used together.
• Systemic Corticosteroids: Reduce calcium absorption, requiring possibly higher calcium doses.
• Ion Exchange Resins (Cholestyramine) and Laxatives (Paraffin Oil): Can reduce Vitamin D absorption.
• Tetracyclines: Calcium may interfere with the absorption of tetracycline antibiotics. To avoid this, take tetracyclines 2 hours before or 4-6 hours after calcium.
• Cardiac Glycosides: Hypercalcemia may increase the toxicity of cardiac glycosides, so regular monitoring of ECG and serum calcium levels is necessary.
• Bisphosphonates & Sodium Fluoride: Take Reef-D Vita at least 3 hours before these medications to avoid reduced absorption of calcium.
• Oxalic and Phytic Acids: Found in foods like spinach and whole cereals, these acids can inhibit calcium absorption. Avoid calcium supplements for 2 hours after consuming these foods.

✔️ Contraindications

• Hypercalcemia: Excessive calcium levels in the blood.
• Hyperparathyroidism: Overactive parathyroid glands leading to high calcium levels.
• Hypercalciuria and Nephrolithiasis: High calcium in urine or kidney stones.
• Severe Renal Insufficiency: Impaired kidney function.
• Hypersensitivity: Allergic reactions to any component of the product.
• Concomitant Digoxin Therapy: Needs careful monitoring due to the risk of calcium-related toxicity.

✔️ Pregnancy & Lactation

• Pregnancy: Daily intake should not exceed 1500 mg of calcium and 600 IU of Vitamin D. High doses can cause permanent hypercalcemia, adversely affecting fetal development.
• Lactation: Reef-D Vita can be used during breastfeeding. Both calcium and vitamin D pass into breast milk, so care should be taken when supplementing the infant.

✔️ Precautions & Warnings

• Serum Calcium Monitoring: Long-term use should be monitored for calcium levels and renal function.
• Renal Function: Caution in those with impaired kidney function, as it may increase the risk of soft tissue calcification or renal damage.
• Sarcoidosis: Increased metabolism of Vitamin D may occur in these patients, requiring frequent monitoring of serum calcium and urinary calcium excretion.
• Immobilized Osteoporosis Patients: There’s a risk of hypercalcemia in immobile patients.

✔️ Storage Conditions

• Store at below 30°C.
• Protect from light and moisture.
• Keep out of the reach of children to prevent accidental ingestion.