Shelcal 500

Therapeutic indications

Shelcal 500 tablet is a supplement that is a fixed-dose combination of calcium and vitamin D3. Calcium is needed in our bodies for strong bones and correct working of muscles, nerves, and cells. Vitamin D3 is important in the absorption of calcium and phosphorus from the gut. Shelcal 500 is used in a number of conditions that include:

• Osteoporosis
• Osteomalacia
• Rickets
• Latent tetany-a muscle disease
• Hypoparathyroidism
• Postmenopausal osteoarthritis
• Vitamin D deficiency
• Calcium deficiency
• Fanconi syndrome
• Stomach ulcer
• Duodenal ulcer
• Renal osteodystrophy
• Chronic renal failure
• Low levels of phosphates
• Acid indigestion
• Heartburn
• Upset stomach
• Stomach gas
• Dietary supplement for breastfeeding or pregnancy and for prednisolone taking post-menopausal women
• Supplement for individuals taking phenytoin and phenobarbital.

Do I need a prescription?

Shelcal 500 can be bought from the local pharmacy and from online drug stores. A doctor’s prescription is a must.

Dosage

The dosage prescribed for Shelcal 500 depends on the health condition, the severity of the disease, gender, age, body weight and reaction to the initial dose. The recommended dose is as follows:

• One tablet (500 mg) should be taken per day.
• In the case that your dose is more than 600 milligrams a day, then the dose should be divided and spaced through the day.

Chemical composition

Shelcal 500 has two key ingredients :

Calcium carbonate 500 mg

Vitamin D3 250 IU

Mechanism of Action (MOA)

Calcium is required for normal body functioning of cells, nerves, muscles, and bones. It is also important in the regulation of muscle contraction and relaxation and in the secretion of hormones some hormones like insulin. Insufficient calcium in the bloodstream results in the body utilizing calcium stored in the bones that results in weakening of the bones. Shelcal 500 provides the body with calcium preventing it from using the one in the bones and also ensures that that taken from the bones is replaced making the bones and teeth stronger. When the levels of calcium in body fluids are of recommended levels, muscle contraction, nerve transmission, and cells work well too.

Vitamin D3 is important in the absorption of calcium and phosphorus from the gut. Thus the vitamin D3 in Shelcal 500 ensures that calcium taken is absorbed. Calcium and phosphorus are used in bone mineralization thus stronger bones and teeth.

Facts on Shelcal

• Calcium an active ingredient in Shelcal 500 can also be obtained from the diet.
• Vitamin D3 an active ingredient in Shelcal 500 is produced under the skin when exposed to sunlight.
• Shelcal 500 is used in pregnancy to ensure that the developing fetus has strong bones.
• Allergic reactions due to active ingredients of Shelcal 500 rarely occur.
• Cholecalciferol an active ingredient in Shelcal 500 was first described in1936.
• Shelcal 500 is not an addictive medication.

Contraindications

The use of Shelcal 500 is not recommended in a number of conditions. Inform your doctor if you have any of the following conditions as they might affect the prescription. The conditions include:

• Hypersensitive to the active ingredients
• Increased levels of phosphate
• Hypercalcemia
• Vitamin D toxicity
• Malabsorption problems
• Use of antacids that have vitamin D supplements or magnesium
• Liver disease
• Kidney disease and kidney stones
• Heart or blood vessels disease
• Low bile levels
• Crohn’s disease
• Sarcoidosis
• Increased parathyroid activity
• Peptic or intestinal active ulcer
• Regular blood transfusions
• Digoxin toxicity
• Achlorhydria
• Dehydration
• Bowel movements that are incomplete or not frequent
• Bone dissolving tumor

Side effects

Shelcal 500 might also cause a number of side effects apart from the desired effects. The side effects do not occur in all individuals. They depend on the reaction to the drug and the duration of use. Some side effects are common and less serious while others are rare and very serious. Inform your doctor about any side effects you experience more so if they do not go away. Side effects include:

• Stomach upset
• Constipation
• Headache
• Drowsiness
• Irritability
• Itching
• Eye infections
• Chest pain
• Bloating
• Dry mouth
• Photophobia
• Pain in the muscles and bones
• Nausea
• Weight loss
• Heart arrhythmia
• High or low blood pressure
• Appetite loss
• Weakness
• Increase in liver enzymes
• Metallic taste in the mouth
• Vomiting
• Nausea
• Albuminuria or protein in the urine
• High levels of nitrogen-containing compounds in the blood(azotemia)
• Increased frequency of urination
• Hypercalcemia
• Metabolic alkalosis
• Milk-alkali syndrome
• Tissue calcification
• Acid rebound occurs with prolonged use
• Hypersecretion of gastric
• Heart arrhythmia
• Skin rash
• Mental or mood changes
• Allergic reactions that include dizziness that is severe, difficulty breathing, rashes, swelling of the tongue, throat, and face.
• Confusion
• Delirium
• Retarded growth in children
• Mouth ulcers
• Sleep disturbances

If you accidentally take an overdose of Shelcal 500, contact your doctor immediately or rush into the emergency center of the nearest hospital and carry with the package or label for the medicine for identification. Taking of an overdose may result in side effects, the symptoms may include a headache, tiredness, drowsiness and weakness, loss of appetite, vomiting, and nausea. Levels of calcium are elevated in blood and you may pass calcium in the urine. You may also experience increased thirst and frequent urge to urinate.

Drug interactions

Notify your doctor if you are taking any medication both over the counter drugs and other prescription drugs, any vitamin supplements and herbal products as they might affect the prescription. Shelcal 500 interacts with a number of drugs and this will ensure this is prevented. Taking Shelcal 500 with other products might affect how it works and might also increase the chances of severe side effects occurring. The following products interact with Shelcal 500:

• Bisphosphates, estramustine, and levothyroxine, when used together with calcium, reduces their absorption.
• Antacids containing magnesium when used concurrent, lead to high magnesium levels in the blood.
• Calcium-containing drugs might result in hypercalcemia
• Vitamin D supplements might lead to high levels of calcium
• Corticosteroids reduce Shelcal 500 effectiveness.
• Shelcal 500 reduces the absorption of some antibiotics that include minocycline, doxycycline, tetracycline, levofloxacin, and ciprofloxacin.
• Shelcal 500 might cause high levels of calcium when used together with thiazide diuretics.
• Shelcal 500 absorption is reduced with cholestyramine, mineral oil and colestipol.
• Shelcal 500 may interfere with cholesterol tests and give a false positive, inform your doctor before the test.
• Shelcal 500 reduces the absorption of atenolol, iron, alendronate, quinolones, Zn and calcium-channel blockers and Na fluoride.
• The cardiac effects of digitalis glycoside may be enhanced by Shelcal 500 and precipitation might occur resulting in intoxication.
• Calcium acetate

What to do if you skip a dose?

When you skip a dose, take it as soon as you realize it. If it is close to the next dose, you can skip it and take the next dose when it is scheduled and then continue with the normal schedule. Do not double the dose to compensate for the skipped dose as it might result in toxicity and side effects. Skipping of doses makes the drug not to be effective. To avoid frequent dose skipping, set a reminder or have a family member remind you when it is time to take the drug.

Precautions

A number of precautions need to be considered when using Shelcal 500. The precautions include:

• Do not use Shelcal 500 if you are allergic to any of the active ingredients.
• Do not take expired Shelcal 500 as it has reduced effectiveness. Always check the package for expiry date when buying the product.
• Store Shelcal 500 way from sunlight and moisture. At a temperature above room temperature.
• While taking Shelcal 500, the serum levels of calcium, phosphorus, and alkaline phosphates need to be monitored closely to avoid toxicity.
• Shelcal 500 should not be used if you have a history of kidney stones
• During breastfeeding and pregnancy, Shelcal 500 should be used with medical supervision and only under the advice from your doctor.
• Use of alcohol with Shelcal 500 is not recommended as it might result in side effects.
• If Shelcal 500 makes you drowsy, it is not recommended that you perform tasks that require mental alertness like the operation of heavy machinery or driving.
• Take Shelcal 500 with a lot of water and preferably two hours after or before taking other medications.
• Shelcal 500 should be used with precaution if you have renal impairment.
• Shelcal 500 usage in the elderly should be closely monitored due to reduced acidity in the stomach that impairs calcium absorption.
• Shelcal 500 should not be used in infants and children.
• Inform your doctor of the medications you are currently using to avoid drug interactions.
• Inform your doctor of any medical conditions.
• Shelcal 500 should not be used in doses higher than those recommended by your doctor. It increases the chance of adverse effects occurring.
• Shelcal 500 might result in a false positive for the cholesterol test,always inform your doctor you are on the medication before taking the test.
• Chewable tablets of Shelcal 500 may contain aspartame and sugar, and thus should be used with caution if you are diabetic or have a history of phenylketonuria.

Different brand and manufacturing companies of the drug

Shelcal 500 is manufactured by two pharmaceuticals:

• Torrent pharmaceutical Ltd
• Elder pharmaceutical Pvt Ltd

Shelcal 500 is also manufactured with different strengths that include:

• Shelcal 250( 250 mg)
• Shelcal HD (1250 mg + 250 IU),
• Shelcal 250 (250 mg + 125IU)
• Shelcal XT(1250 MG + 2000 IU)

Substitutes of the drug

Substitute drugs having the same strength and function as Shelcal 500 include:

• Tricium 500 mg tablet – Corona Remedies Pvt Ltd
• Abocal 500 mg Tablet – Abbott India Limited
• Cipcal 500 mg Tablet – Cipla Ltd
• Dalycal 500 mg Tablet – Systopic Laboratories Pvt Ltd
• Tayo Tablet – Eris Lifesciences Pvt Ltd
• CM-D3 Tablet – Foregen Healthcare Ltd
• Ossopan 500 tablet – TTK Healthcare Ltd
• Sandocal 500 with Vit. D3 Tablet – Novartis India Ltd
• Ducal –D – Morepen Laboratories Ltd
• Microcal – Micro Labs Ltd
• Motocal-CCM – Mitoch Pharmaceutical Pvt Ltd
• Oyst O-Cal 250 – Cadila Pharmaceuticals Ltd.

References

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