Caldefix

Caldefix Calcium is available as effervescent, biconvex, cylindrical tablets, white or almost white in colour, with a distinct orange scent. 

Each tablet contains 1000 mg of elemental calcium, in the form of calcium carbonate, and 880 IU of cholecalciferol. The effervescent form allows for rapid dissolution in a glass of water, producing a solution that is easy to administer, which may improve treatment compliance, particularly in the elderly or in patients with difficulty swallowing.

Caldefix effervescent is indicated for the treatment of calcium and vitamin D deficiency, particularly in the elderly, in whom cutaneous synthesis of vitamin D and dietary intake may be insufficient. 

It is also used as an adjunct in the specific treatment of osteoporosis, in patients with combined calcium and vitamin D deficiency or at high risk of developing it. 

The administration of Caldefix is intended to support bone mineralisation, reduce bone loss and complement anti-osteoporotic therapies, thereby contributing to the prevention of fragility fractures.

The recommended dose is one effervescent tablet of Caldefix per day, dissolved in a glass of water and taken immediately after dissolution. Caldefix is not recommended for children under 12 years of age.

It should be taken during or after meals to optimise gastrointestinal tolerability. 

The use of Caldefix effervescent is contraindicated in patients with hypersensitivity to calcium carbonate, cholecalciferol, soya oil, peanuts or any of the excipients. 

Furthermore, it must not be administered in cases of hypercalcaemia, hypercalciuria, hypervitaminosis D or in patients with kidney stones. These conditions may be exacerbated by calcium and vitamin D supplementation, increasing the risk of metabolic and renal complications.

Caution is required in patients with renal impairment, in those predisposed to the formation of kidney stones, and in people over the age of 65. 

Patients treated with digitalis or thiazide diuretics, those with sarcoidosis, or patients who are bedridden due to osteoporosis also require careful monitoring. In these cases, the doctor will periodically check serum calcium levels, urinary calcium levels and kidney function, and may decide to adjust the dose or discontinue treatment. 

Like all medicines, Caldefix can cause side effects, although not everybody gets them. 

Rare reactions include constipation, bloating, flatulence, nausea, abdominal pain, diarrhoea, itching, transient skin rashes or hives, as well as increased levels of calcium in the blood or urine. 

Very rarely, the soya oil contained in the product may cause allergic reactions. The occurrence of any adverse reaction should be reported to your doctor or pharmacist.

Concomitant administration of Caldefix with digitalis preparations may increase their toxicity, promoting the onset of cardiac arrhythmias, which is why close medical supervision is necessary. 

Thiazide diuretics may increase the risk of hypercalcaemia, whilst bisphosphonates or sodium fluoride must be administered at least two hours apart from Caldefix. 

Tetracyclines must be administered at least three hours before or after Caldefix to avoid reduced absorption. Phenytoin, barbiturates and glucocorticoids may reduce the effect of vitamin D3. Foods rich in oxalic acid, phosphates or phytic acid may interfere with calcium absorption.

An overdose of Caldefix may cause hypercalcaemia and hypercalciuria, which manifest as nausea, vomiting, intense thirst, polyuria, constipation and, in severe cases, cardiac or renal disorders. 

In the event of an overdose, the patient must contact their doctor or the emergency services immediately, taking the medicine packaging with them.

Caldefix must be stored at temperatures below 25 °C, in the original packaging, protected from moisture. The medicine must be kept out of the reach and sight of children and must not be used after the expiry date stated on the packaging. Unused medicines must be disposed of in accordance with the pharmacist’s recommendations, in order to protect the environment.

• NIH, Calcium
• WebMD, Vitamin D
• PubMed, Calcium and Vitamin D: Skeletal and Non-Skeletal Health
• MDPI, Vitamin D and calcium — an overview, analysis of metabolism and the importance of concomitant supplementation