Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium Pharmacology

Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium

About Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Mechanism of Action of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Pharmacokinets of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Onset of Action for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Duration of Action for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Half Life of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Side Effects of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Contra-indications of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Special Precautions while taking Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Pregnancy Related Information
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Old Age Related Information
N/A
Breast Feeding Related Information
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Children Related Information
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Indications for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Interactions for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Typical Dosage for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Schedule of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Storage Requirements for Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Effects of Missed Dosage of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Effects of Overdose of Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium
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Iron (Ferrous fumarate)

About Iron (Ferrous fumarate)
Iron (II) salt of fumaric acid, Oral iron preparation, Antianemic,hematinic.
Mechanism of Action of Iron (Ferrous fumarate)
Ferrous fumarate is used as a source of iron for iron-deficiency anaemia. It is given by mouth in usual doses of up to 600 mg daily (equivalent to about 200 mg of iron daily). Iron formulations exert haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues.
Ferrous fumarate has similar efficacy as that of Ferrous sulphate.But it is more stable and almost tasteless as compared to Ferrous fumarate and it does not precipitate proteins and does not interfere with enzymes of digestive system.
Pharmacokinets of Iron (Ferrous fumarate)
Absorption: Absorbed orally in ferrous form and poorly absorbed in healthy individuals (about 10%) but in patients suffering from iron deficiency anaemia up to 60% dose is absorbed. Distribution: Transported in a transferrin bound form in to bone marrow for incorporation in to haemoglobin. Metabolism: Iron liberated by destruction of haemoglobin is reused by the body. Excretion: Excretion of iron is minimal. Loss usually occurs in nails, faeces, urine, hair, sweat, and bile.

Onset of Action for Iron (Ferrous fumarate)
N/A
Duration of Action for Iron (Ferrous fumarate)
N/A
Half Life of Iron (Ferrous fumarate)
N/A
Side Effects of Iron (Ferrous fumarate)
1.Nausea
2.Epigasttric distress
3.Vomiting
4.Constipation
5.Diarrhoea
6.Black stools
7.Temporary staining of teeth with liquid formulations.
Contra-indications of Iron (Ferrous fumarate)
1.Haemolytic anaemia unless iron deficiency anaemia is also present
2.Haemochromatosis
3.Haemosiderosis
4.Peptic ulcer
5.Regional enteritis
6.Ulcerative colitis
7.Those receiving repeated blood transfusions
Special Precautions while taking Iron (Ferrous fumarate)
1. Prolonged use
2. Minimise gastrointestinal discomfort by taking along with meals and gradually increasing the recommended dosage
3. Discontinue if intolerance occurs
4. Higher doses are required for geriatric patients
Pregnancy Related Information
May be used
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Iron (Ferrous fumarate)
1. Iron deficiency
2. Iron deficiency anaemia
Interactions for Iron (Ferrous fumarate)
N/A
Typical Dosage for Iron (Ferrous fumarate)
Oral:
Adults: Starts with 50 to 100mg 2 to 3 times daily. Adjust the dosage based on patient`s response.
Children: 4 to 6mg/kg daily in three divided doses.
Schedule of Iron (Ferrous fumarate)
H
Storage Requirements for Iron (Ferrous fumarate)
Store in a well closed container in a cool dry place. Protect from light.
Effects of Missed Dosage of Iron (Ferrous fumarate)
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Iron (Ferrous fumarate)
Treatment includes immediate support of airway, respiration, and circulation. In conscious patients induce emesis with ipecac; if not empty stomach by gastric lavage. Follow emesis with lavage, using a 1% sodium bicarbonate solution to convert iron to less irritating poorly absorbed form. Take abdominal X-ray to determine presence of excess iron. Deferoxamine may be used for systemic chelation if serum levels of iron exceed 350mg/dl.

Vit B12

About Vit B12
N/A
Mechanism of Action of Vit B12
Vitamin B12 is an essential constituent for growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. Vitamin B12 is converted in to coenzyme B12 in the tissues which is essential for conversion of methyl-malonate to succinate and synthesis of methionine from homocystine. It is also associated with fat and carbohydrate metabolism and protein synthesis. Cells characterized by rapid division such as epithelial cells, bone marrow, and myeloid cells appear to have greatest requirement of Cyanocobalamin.
Pharmacokinets of Vit B12
Absorption: Absorbed irregularly after oral administration and absorption depends on Ca and intrinsic factor. It is also administered subcutaneously and intramuscularly.
Distribution: Distributed in to liver, bone marrow, and other tissues. It crosses the placenta and appears in breast milk.
Metabolism: It is metabolized in liver.
Excretion: In normal dosage it is reabsorbed from bile and a minute portion is excreted through urine but the extra drug is excreted through urine.
Onset of Action for Vit B12
N/A
Duration of Action for Vit B12
N/A
Half Life of Vit B12
N/A
Side Effects of Vit B12
1. Anaphylaxis
2. Anaphylactoid reactions
3. Pain and burning sensation at injection site
4. Itching
5. Urticaria
6. Transient diarrhea
7. Peripheral vascular thrombosis
8. Pulmonary oedema
Contra-indications of Vit B12
1. Hypersensitivity to the drug
2. Leber`s disease
Special Precautions while taking Vit B12
1. Anemic patients with coexisting cardiac, pulmonary and hypertensive diseases.
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
NEONATES : Use with caution
Indications for Vit B12
1. Vitamin B12 deficiency
2. Pernicious Anaemia
3. Peripheral neuropathy (diabetic, alcoholic, and drug induced)
Interactions for Vit B12
N/A
Typical Dosage for Vit B12
I.M., S.C.:
Pernicious Anaemia: 100mcg daily for 1 week followed by the same dose given on alternate days for 7 doses and then every 3 to 4days for another 3 weeks. This regimen should be followed by 100mcg monthly for life. Concurrently administer folic acid if required.
Vitamin B12 deficiency other than pernicious Anaemia: 30mcg daily for 5 to 10days depending up on the severity of the condition.
Maintenance dosage: 100 to 200mcg once monthly.
Children: 100mcg I.M. or S.C. over the course of 2 or more weeks.
Maintenance dosage: 60mcg monthly I.M. or S.C.
Schilling test flushing dose:
Adults and Children: 1000mcg I.M. in single dose
Recommended RDA (recommended dietary allowance) for Vitamin B12:
Infants up to 6months of age: 0.3mcg.
Children age 6 months to 1 year: 0.5mcg.
Children age 1 to 3: 0.7mcg.
Children age 4 to 6: 1mcg.
Children age 7 to 10: 1.4mcg.
Children age 11 to adult: 2mcg..
Pregnant women: 2.2mcg.
Breast feeding women: 2.6mcg.
Schedule of Vit B12
C
Storage Requirements for Vit B12
Store at room temperature range of 15 to 30 degree C.in a light resistant well closed container in a dry place.
Effects of Missed Dosage of Vit B12
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vit B12
Not applicable. Even in large doses Vitamin B12 isn`t usually toxic.

Folic Acid

About Folic Acid
Dietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.
Mechanism of Action of Folic Acid
Folic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of "formate pool". 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.
Pharmacokinets of Folic Acid
Absorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.
Onset of Action for Folic Acid
Oral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic Acid
Oral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic Acid
N/A
Side Effects of Folic Acid
N/A
Contra-indications of Folic Acid
N/A
Special Precautions while taking Folic Acid
1. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Folic Acid
1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid
1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic Acid
Oral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.
Schedule of Folic Acid
C1 (Oral)
C (Parenteral)
Storage Requirements for Folic Acid
Store at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.
Effects of Missed Dosage of Folic Acid
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Folic Acid
Relatively non toxic. Provide symptomatic treatment and supportive measures.

Vitamin D3

About Vitamin D3
N/A
Mechanism of Action of Vitamin D3
Vitamin D3 is a form of vitamin D. It is also called as Cholecalciferol.7-Dehydrocholesterol is the precursor of vitamin D3 and only forms the vitamin after being exposed to UV radiation.After exposure to the sun, cholecalciferol is sent to the liver to be hydroxylated where it becomes 25-Hydroxyvitamin D3.Next, it is sent to the kidney and once again hydroxylated becoming 1,25-Hydroxyvitamin D3. 1,25-Hydroxyvitmain D3 is the active form of vitamin D3, for this reason vitamin D is often referred to as a prohormone.Vitamin D exerts it`s action by influencing calcium homoeostasis. It increases the intestinal absorption of calcium and phosphate. It binds to the cytoplasmic Vitamin D receptor and translocates to the nucleus and thus increases the synthesis of specific m RNA and regulates protein synthesis. It increases the synthesis of a carrier protein for calcium called "calbindin" or calcium binding protein. Activation of Vitamin D receptor enhances endocytotic capture of calcium and it`s transport across duodenal mucosal cells in a vesicular form. Vitamin D promotes resorption of calcium and phosphate from bone by enhancing recruitment and differentiation of osteoclast precursors in the bone remodeling units. It helps in bone mineralization.
Pharmacokinets of Vitamin D3
Absorption: Well absorbed orally in the presence of bile salts, Malabsorption and steatorrhoea interfere with it`s absorption.
Distribution: Widely distributed in a protein bound form. It is stored in adipose tissue and liver.
Metabolism: It is hydroxylated in to both active and inactive metabolites and also metabolized in kidney.
Excretion: Metabolites are excreted mainly through bile.
Onset of Action for Vitamin D3
N/A
Duration of Action for Vitamin D3
N/A
Half Life of Vitamin D3
N/A
Side Effects of Vitamin D3
1. Hypercalcaemia
2. Fatigue
3. Weakness
4. Diarrhoea
5. Vomiting
6. Sluggishness
7. Albuminuria
8. Polyuria
9. Calcification of soft tissues (blood vessels, parenchymal organs including heart)
10. Arrhythmias
11. Renal stones
12. Growh retardation in children
13. Hypertension
14. Anorexia
15. Nausea
16. Constipation
17. Elevated liver enzymes
Contra-indications of Vitamin D3
1. Hypercalcaemia
2. Hypervitaminosis D
3. Renal osteodystrophy with hyperphosphatemia
4. Renal impairment
Special Precautions while taking Vitamin D3
1. Renal diseases
2. Renal stones
3. Cardiac diseases
4. Arteriosclerosis
5. Coronary diseases
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Vitamin D3
1. Rickets and Osteomalacia
2. Hypoparathyroidism
3. Fanconi`s syndrome
4. Osteoporosis
Interactions for Vitamin D3
Antacids: Hypermagnesemia may develop in patients on renal dialysis who take magnesium containing antacids.
Digitalis glycosides: May precipitate cardiac arrhythmias due to hypercalcemia.
Verapamil: Atrial fibrillation may occur.
Cholestyramine: Intestinal absorption of Vitamin D may be reduced.
Mineral Oil: Prolonged use of mineral oil may result in reduced absoprtion of Vitamin D.
Phenytoin, Barbiturates: Half life of vitamin D may be reduced.
Thaizide diuretics: Hypoparathyroid patients on Vitamin D may develop hypercalcemia due to thiazide diuretics.
Typical Dosage for Vitamin D3
Oral:
Adults:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 7.5mg orally or 250mcg I.M.
Vitamin dependent Rickets: 250mcg to 1.5mg daily
Hypoparathyroidism: 625mcg to 5mg daily with calcium supplements
Fanconi`s syndrome: 1.25 to 5mg daily
Osteoporosis: 25 to 250mcg daily or 1.25mg once weekly with calcium and fluoride supplements.
Hypophosphatemia: 250mcg to 1.5mg along with phosphate supplements
Children:
Nutritional Rickets and Osteomalacia: 25 to 125mcg daily in normal gastrointestinal absorption. In severe malabsorption; 250mcg to 625mcg orally
Vitamin dependent Rickets: 75 to 125mcg daily.
Fanconi`s syndrome: 625mcg to 1.25mg daily
Hypophosphatemia: 1 to 2mg daily with phosphate supplements. Increase the dose in increments of 250 to 500mcg at intervals of 3 to 4months until desired therapeutic response is obtained.

Schedule of Vitamin D3
N/A
Storage Requirements for Vitamin D3
Store in a well closed container in a cool place. Protect from light and excess heat. Keep out of reach of children.
Effects of Missed Dosage of Vitamin D3
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vitamin D3
Provide supportive and symptomatic treatment. Stops the treatment and starting a low calcium diet. Increases the fluid intake and administer Loop diuretics like furosemide may be given with saline I.V. infusion to increase calcium excretion. Calcitonin may decrease hypercalcaemia.

Vitamin C

About Vitamin C
Water soluble vitamin, antioxidant.
Mechanism of Action of Vitamin C
Vitamin C exerts it`s action by influencing the biologic oxidations and reductions used in cellular respirations. It directly stimulates collagen synthesis and maintains intracellular connective tissue. It involves in various metabolic reactions such as 1).Hydroxylation of praline and lysine residues of protocollagen which is essential for formation and stabilization of collagen triple helix, 2).hydroxylation of carnitine, 3).Conversion of folic acid to folinic acid, 4).biosynthesis of adrenal steroids, catecholamines, oxytocin, and ADH, 5).Metabolism of cyclic nucleotides and prostaglandins. Vitamin C is important in resistance to infections.
Pharmacokinets of Vitamin C
Absorption: Well absorbed orally.
Distribution: Widely distributed both extracellularly and intracellularly, It crosses the placenta and also distributed in to the breast milk.
Metabolism: Metabolized in the liver; partly oxidized in to active dehydroascorbic acid and inactive metabolites.
Excretion: Inactive metabolites and extra drug is excreted through urine.
Onset of Action for Vitamin C
N/A
Duration of Action for Vitamin C
N/A
Half Life of Vitamin C
N/A
Side Effects of Vitamin C
1. Discomfort at injection site
2. Acid urine
3. Renal calculi
4. Oxaluria
Contra-indications of Vitamin C
No known contraindications
Special Precautions while taking Vitamin C
1. Renal impairment
2. Ingestion of large doses during pregnancy has resulted in scurvy in neonates
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vitamin C
1. Scurvy
2. Prophylaxis and treatment of vitamin C deficiency
3. As an antioxidant to maintain natural colour and flavour of food items
4. For acidification of urine
5. Capillary fragility
6. Dental caries

Interactions for Vitamin C
Oral contraceptives and estrogens: Vitamin C increases serum levels of oestrogen resulting in adverse reactions .
Warfarin: The anticoagulant effects of warfarin is reduced.
Lab Tests: Large doses (>500 mg) of vitamin C may cause false negative urine glucose determinations. May result in false negative amine dependent stool occult blood tests.
Typical Dosage for Vitamin C
Oral:
Adults: 50 to 1000mg/day depending up on the requirement.
Pregnancy and lactation: 100 to 150mg/day
Children: 30 to 100mg/day.
Scurvy:
Oral:
Adults: 1000mg twice daily to thrice daily.
Children: 300mg to 1000mg daily.
Sub clinical scurvy:
Oral, S.C., I.M., or I.V.: 100 to 250mg once daily or twice daily depending up on the severity of the condition. Then give a maintenance dosage of 50mg/day.
Children: 100 to 300mg depending up on the severity. Then give a maintenance dose of 35mg/day.

Schedule of Vitamin C
C1 (Oral)
C (Parenteral)
Storage Requirements for Vitamin C
Store in a cool dry area in a well closed container. Protects from moisture, light and direct heat.
Effects of Missed Dosage of Vitamin C
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vitamin C
Discontinue the therapy and provide symptomatic and supportive measures.

Calcium

About Calcium
Calcium is necessary for cardiac function, muscle contraction, nervous activity, coagulation of blood and for maintaining structural integrity of cell membranes.
Plasma concentration of calcium is kept in normal range by three endocrine factors which control metabolism of calcium. These are (a) Parathyroid hormone, (b) Calcitonin, (c) Vitamin D. Calcium in plasma is bound to albumin, is complexed with anions (e.g. phosphate) and as diffusible ionic calcium. The physiological effects are exerted by ionic calcium. The predominant source of calcium is dairy products and the daily intake varies from 200 - 2500 mg. Adequate calcium intake is particularly important during periods of bone growth in childhood and adolescence and during pregnancy and lactation.
Patients with advanced renal insufficiency exhibit phosphate retention and some degree of hyperphosphataemia. The retention of phosphate plays a pivotal role in causing secondary hyperparathyroidism associated with osteodystrophy and soft tissue calcification. Calcium acetate, when taken with meals, combines with dietary phosphate to form insoluble calcium phosphate which is excreted in the faeces.
Deficiency signs and symptoms: Osteoporosis, pathological fractures, brittle nails and hair.
Mechanism of Action of Calcium
Calcium is essential for maintaining the functional integrity of nervous, muscular, and skeletal system. It controls excitability of nerves and muscles and regulates permeability of cell membrane. It also regulates cell adhesion and maintains integrity of cell membrane. Calcium acts as intracellular messenger for hormones, autacoids, and transmitters. It is required for excitation-contraction coupling in all types of muscle and excitation-secretion coupling in exocrine and endocrine glands. It is essential for release of transmitters from nerve endings and other release reactions. It is also essential for impulse generation in heart and determines level of automaticity and
A-V conduction. Calcium is also required for blood-coagulation.
Pharmacokinets of Calcium
Absorption: Actively absorbed from gastrointestinal tract in an ionized form; and vitamin D in it`s active form is required for calcium absorption, Distribution: Distributed mainly in to skeletal tissue (99%) and 1% is distributed equally between the intracellular and extra cellular fluid. CSF levels are about half of the serum calcium levels, Metabolism: Not significantly metabolized in the body, Excretion: Excreted mainly through faeces and a small amount is excreted through urine.
Onset of Action for Calcium
N/A
Duration of Action for Calcium
N/A
Half Life of Calcium
N/A
Side Effects of Calcium
1.Constipation
2.Bloating
3.Excess gas
4.Anorexia
5.Nausea
6.Vomiting
7.Abdominal pain
8.Thirst
9.Hypercalcaemia
10.Polyuria
11.Dry mouth
12.Delirium
13.Confusion
Contra-indications of Calcium
1.Renal calculi
2.Hypophosphataemia
3.Hypercalcaemia
4.Ventricular fibrillation.
Special Precautions while taking Calcium
1.Renal impairment
2.Cardiac diseases
3.Sarcoidosis
4.Cor pulmonale
5.Respiratory acidosis
6.Respiratory failure
7.End stage renal failure
8.Hypoparathyroid patients
9.Digitalized patients
10.Prolonged use of therapeutic amounts.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Calcium
1.Hypocalcaemia
2.Calcium and vitamin D deficiency
3.Calcium deficiency during pregnancy and lactation
4.Rickets
5.Prevention of osteoporosis in postmenopausal women
6.Chronic renal failure.
Interactions for Calcium
N/A
Typical Dosage for Calcium
Oral: 500mg to 2g daily in two to four divided doses.
Hypocalcaemia:
Adults: 1g daily. Increases to 2g daily if required.
Prevention of osteoporosis: 1 to 1.5g daily.
Children: 45 to 65mg/kg daily.
Neonates: 50 to 150mg/kg and should not exceed 1g.

Schedule of Calcium
N/A
Storage Requirements for Calcium
Store in a well closed container in a cool and dry place. Protect from light.


Effects of Missed Dosage of Calcium
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Calcium
Remove calcium from stomach by induced emesis and gastric lavage. Provide symptomatic treatment and supportive measures.

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Iron (Ferrous fumarate) + Vit B12 + Folic acid + Vitamin D3 + Vitamin C+ Calcium is a generic medicine name and there are several brands available for it. Some of the brands for iron (ferrous fumarate) + vit b12 + folic acid + vitamin d3 + vitamin c+ calcium might be better known than iron (ferrous fumarate) + vit b12 + folic acid + vitamin d3 + vitamin c+ calcium itself. If the pharmacy that's willing to deliver medicines to your home doesn't have iron (ferrous fumarate) + vit b12 + folic acid + vitamin d3 + vitamin c+ calcium in stock, you can ask for one of the branded alternatives for iron (ferrous fumarate) + vit b12 + folic acid + vitamin d3 + vitamin c+ calcium.