Coralex D | 500mg+200IU

✔️ Dosage and Administration

Tablets

• One tablet once or twice daily, or as directed by a physician.
• Take with plenty of water.
• Taking the tablet after meals may improve absorption.

✔️ Most people tolerate Coralex D well, but possible side effects include:

Gastrointestinal Effects

• Constipation
• Stomach irritation
• Nausea
• Vomiting
• Abdominal discomfort

Metabolic Effects

• Hypercalcemia (rare, usually with excessive doses)

Other Effects

• Dry mouth
• Reduced appetite
• Drowsiness
• Irregular heartbeat
• Allergic reactions
• Skin rash (occasionally associated with vitamin D supplementation)

✔️ Benefits

Calcium is essential for numerous physiological processes, including:

• Bone and teeth formation
• Muscle contraction
• Nerve transmission
• Blood clotting
• Normal heart function

When dietary calcium intake is insufficient, the body draws calcium from bones, leading to bone weakening over time.

Vitamin D3 enhances calcium absorption from the gastrointestinal tract and helps maintain proper calcium balance. It also supports bone mineralization and bone formation.

The calcium in Coralex D is derived from coral sources. Its mineral composition closely resembles that of human bone and provides an effective source of elemental calcium. Combined calcium and vitamin D supplementation has been shown to:

• Improve bone density
• Reduce fracture risk
• Help prevent and treat osteoporosis

✔️ Several medications and foods may affect calcium or vitamin D absorption:

Thiazide Diuretics

• May reduce urinary calcium excretion.
• Increase the risk of hypercalcemia.
• Regular calcium monitoring is recommended.

Corticosteroids

• Can decrease calcium absorption.
• Higher calcium supplementation may be required.

Cholestyramine and Paraffin Oil

• May reduce vitamin D absorption from the intestine.

Tetracycline Antibiotics

• Calcium may reduce antibiotic absorption.
• Take tetracyclines at least:
  • 2 hours before, or
  • 4–6 hours after Coralex D.

Cardiac Glycosides (e.g., Digoxin)

• Hypercalcemia may increase toxicity.
• ECG and calcium monitoring are recommended.

Bisphosphonates and Sodium Fluoride

• Calcium can reduce absorption.
• Take Coralex D at least 3 hours apart.

Food Interactions

Foods rich in oxalic acid or phytic acid may decrease calcium absorption:

• Spinach
• Rhubarb
• Whole grains and cereals

Avoid taking calcium supplements within 2 hours of consuming large amounts of these foods.

✔️ Excessive intake may result in:

Hypervitaminosis D

Hypercalcemia

Symptoms may include:

• Loss of appetite
• Excessive thirst
• Nausea and vomiting
• Constipation
• Abdominal pain
• Muscle weakness
• Fatigue
• Increased urination
• Bone pain
• Kidney stones
• Kidney calcification
• Mental confusion
• Cardiac arrhythmias

Severe untreated hypercalcemia can lead to:

• Coma
• Permanent kidney damage
• Soft tissue calcification
• Death

Management

Treatment may involve:

• Immediate discontinuation of calcium and vitamin D
• Rehydration
• Loop diuretics
• Bisphosphonates
• Calcitonin
• Corticosteroids
• Monitoring of electrolytes, kidney function, ECG, and urine output

✔️ Coralex D should not be used in patients with:

• Hypercalcemia (high blood calcium)
• Hyperparathyroidism
• Hypercalciuria (high urinary calcium)
• Kidney stones (nephrolithiasis)
• Severe kidney impairment
• Known hypersensitivity to any component of the formulation

Patients taking digoxin require close medical supervision and calcium monitoring.

✔️ Pregnancy & Lactation

Pregnancy

Coralex D may be used during pregnancy when calcium or vitamin D deficiency exists.

Recommended daily limits during pregnancy:

• Calcium: up to 1500 mg daily
• Vitamin D3: up to 600 IU daily

Excessive intake should be avoided because prolonged hypercalcemia may adversely affect fetal development.

Breastfeeding

Coralex D can be used while breastfeeding. Both calcium and vitamin D pass into breast milk, which should be considered if the infant receives additional vitamin D supplementation.

✔️ Use Coralex D cautiously in patients with:

• Kidney disease
• Sarcoidosis
• Osteoporosis with prolonged immobilization
• History of kidney stones
• High risk of hypercalcemia

During long-term treatment, monitoring should include:

• Serum calcium levels
• Kidney function (serum creatinine)
• Urinary calcium excretion when appropriate

Particular caution is required in:

• Elderly patients
• Patients taking cardiac glycosides
• Patients taking diuretics

Additional calcium or vitamin D supplements should only be used under medical supervision.

✔️ Storage:

• Store below 30°C.
• Protect from light and moisture.
• Keep out of reach of children.