Description:
Calcium
It is the vital for the formation of strong boner and teeth and for the maintenance of the healthy 'am It is also important in the maintenance of regular heart heal and the transmission of n impulses. Calcium lowers cholesterol levels and helps to prevent cardio vascular disease. This important mm-lo is also essential is blood clotting and prevents bone loss associated with osteoporosis as well.
Virtually all body calcium (99%) in found in the skeleton. The reminder is divided between the teeth, soft tissues and extra regular fluid.
Daily requirement am in the region of 500 to 600000/day but increase during adolescence, pregnancy, lactation, the menopause and in elderly subjects, They can be as 1500mg/day.

Vitamin-D
leave the intestine and enter the bloodstream. In absence of vitamin-D virtually no calcium is absorbed. Calcium from food and supplements ('Salts) are poorly absorbed but when given with vitamin-D absorption of calcium may increase up to 80"0. Moreover, vitamin-F) prevents bone loss
Decreasing renal excretion of calcium.

Stimulating osteoblast activity (bone formation)
Calcium monotherapy in the treatment of osteoporosis is only wastage of money.
Calcium Plus Vitamin D adjuvant to anti convulsives and anti-corticosteroids:
During long term (more than six month ) treatment with anticonvulsant corticosteroid (Phenobarbiton. Primidonc, Phenytoin,cortisone, Prednisolone etc). drugs a gradual decline in the calcium plasma levels are observed, increasing the risk of osteoporosis. This hypocalcaemia is compensated by secondary hyperparathyroidism which in turn can cause Further skeletal decalcilication. Thus calcium & vitamin D combindly is necessary in patients receiving long-tern anticonvulsive corticosteroid therapy.

In Pregnancy:
Vitamin D3 a pro hormone developmental hormone responsible for regulating calcium and phosphonts. Vitamin D and calcium supplementation given at the seventh month of pregnancy enables the normal levels of vitamin D and calcium to be maintained in pregnant Women & also prevent the neonatal hypocalcaemia.

Diabetes:
Vitamin D deficiency impairs glucose metabolism by reducing insulin secretion. This is likely to increase the risk of diabetes in areas where vitamin D deficiency is common.
In a 1997 study looking at the links between environmental factors and type 11 diabetes, Vitamin D levels were assessed in 142 Dutch men aged from 70 to 80 years of age. 39% were found to have low vitamin D levels and tests showed that low vitamin D levels increased the risk of glucose intolerance.

Heart disease:
Low vitamin D levels may also increase the risk of atherosclerosis. Research published in 1997 in the American Heart Association Journal Circulation suggests that a lower level of vitamin D increases the risk of calcium build-up in atherosclerotic plaques and that higher levels reduce the risk of build-up. Researchers at UCLA School of Medicine measured that vitamin D levels in the blood of 173 men and women at risk of heart disease and also measured the build-up of calcium in coronary artery ( a common finding in coronary artery disease ). The results suggest that calcium may regulate calcium deposition in the arteries as well as in the hone.

Nervous system:
Carefully regulation of calcium levels is vital for normal nerve impulse transmission and muscle :.contraction. Vitamin D along with Calcium play a role in the functioning of healthy nerves and muscles by regulating the level of calcium in the blood.

Calcium & vitamin D's effect on Teeth:
The most important role of calcium & vitamin D combindly are to maintain blood calcium level within an acceptable range. Ilomeostasis form of calcium in the body is vital for many body functions including normal growth and development of teeth and as well as for the maintenance of the healthy gums. It enable teeth to harden by increasing the deposition of calcium into its structure.
Calcium & vitamin D deficiency leads demineralization and some of the specific disorders of the teeth.

Other effects:
Vitamin D and calcium deficiency may also play a role in inflammatory bowel disease, tuberculosis, stroke and high blood pressure.

Prescribing Information
Boncal-D
(Calcium& vitamin-D)

Composition:
Each Tablet Boncal-D contains:
Calcium Carbonate ---1000mg (equivalent to calcium 400mg)
Vitamin-D3 2ntg (equivalent to 2001U)

Indication and uses:
Treatment of osteoporosis, rickets, osteomalacia. tetany and hypeparathyroidism.

In pregnancy & lactation due to increases demand.
Prevention of demineralization and ensure normal y,rowth and development of teeth and as well as for the maintenance of the healthy gusts. ftIn kidney disease and pancreatitis.

During therapy with anti-Convulsives/anticorlicosteroids medication.

Pre & post menopause.

The prevention and treatment calcium deficiency/vitamin-D deficiency specially in the housebound and institutionalized elderly subjects.
Osteoporosis is a Silent risk factor for facture Just as hypertension is for stroke.
One in every four women over the age of 50 has osteoporosis.
One in eight men over 50 also has the disease.
Some 200 million people around the world are affected by osteoporosis.

Dosage & Administration:
Adults and Elderly and children above 12 years of age: As a dietary supplement, 1/2 tablets per day, preferable one tablet each morning sod evening or as directed by the Physicians.

Side-effects:
The use of calcium supplements has, rarely, given rise to mild gastro-intestinal disturbances, such as constipation, flatulence, nausea ,gastric pain, diarrhea.
Following administration of vitamin D supplements occasional skin rash has been reported. Hypercalciuria, and in rare cases hypercalcaemia have been seen with a long term treatment at high dosages.

Precautions:
Renal impairments, sarcoidosis, concurrent admin of thiazide diuretics may increase the risk of hypercalcaemia

Contraindications:
Affections rmpanied by hypemaleemic syndrame,hypercaiciuria,calcium stone, hypersensihvith .o vitamin D, immobilized subjects ( high doses).

Over dosage:
Clinical signs (anorexia,polydypsia,polyuria, constipation, and hypertension) Paraclinical signs (hypeecalcemia, hypecalciuria ).

Interactions with Drugs:
The cholesterol - lowering drug, cholestyramine and mineral oil laxatives interfere with the absorption of .calcium and vitamin D. Alcohol interferes with the conversion of vitamin D to its biologically active form. People taking certain anticonvulsant drugs, such as phenytion, may decrease the activity of vitamin D by
increasing its metabolism. People taking this drug se likely to be at increased risk of osteoposis and have highly vitamin D and calcium requirement.

Storage:
Keep in coal preferably lower than 25 C dry place and protected from light and heat Keep container tightly sealed.

Presentation:
60 tablets in each bottle.


Reference
1. Calcium supplernent (systemic) Advice for the patient. USP DI Desktop Series VoL 2004.

2. Dawcon Hughes B; Harris Ss; Krall EA; Dallal GE Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997 Sep,337:10,670-6

3. Vitamin D3 more potent than D2, further avidence. Nutra USA Ingredients.com.Novis 2004.

4. Vitamin D substraces. Matrindale, the extra phamacopia 1999, 1366-68.