Ostogen Plus Effervescent Tablet

✔️ Dosage & Administration

Adults:

1 film-coated tablet twice daily, preferably with meals and a full glass of water
Children (3–7 years):

1 effervescent tablet once daily
Children (7 years and older):

1–2 effervescent tablets daily

Best taken with or just after meals for optimal absorption

✔️ Each film-coated tablet contains:

• Calcium Carbonate BP (equiv. to 600 mg elemental Calcium)
• Vitamin D3 BP (Cholecalciferol) 200 IU
• Magnesium Oxide BP (equiv. to 40 mg Magnesium)
• Manganese Sulfate Monohydrate BP (equiv. to 1.8 mg Manganese)
• Cupric Oxide (equiv. to 1 mg Copper)
• Boron Citrate (equiv. to 250 mcg Boron)
• Zinc Oxide BP (equiv. to 7.5 mg Zinc)
• Each effervescent tablet contains:
  Same ingredients as above, but with Vitamin D3 400 IU

✔️ Pharmacology

• Ostogen Plus EF provides a scientifically balanced blend of macro- and micronutrients essential for bone strength.
• Calcium and Vitamin D3 are vital for bone mineralization.
• Magnesium supports bone rigidity and heart-muscle function.
• Zinc, Copper, Manganese, and Boron play crucial roles in bone matrix formation and mineralization.
  Deficiencies in these nutrients are commonly observed in patients with osteoporosis.

✔️ Drug Interactions

• Thiazide diuretics may increase the risk of hypercalcemia
• Vitamin D3 effectiveness may be reduced by phenytoin, barbiturates, or glucocorticoids

Calcium can reduce the absorption of:

• Thyroxine
• Bisphosphonates
• Iron supplements
• Tetracycline or quinolone antibiotics

Allow at least 4 hours between taking calcium and any of the above

✔️ Contraindications

• Hypercalcemia (e.g., due to bone metastases or hyperparathyroidism)
• Severe renal impairment
• Vitamin D3 toxicity
• Hypersensitivity to any of the ingredients
• Immobilization-induced osteoporosis with high calcium levels
• History of renal stones or severe hypercalciuria

✔️ Side Effects

Nausea, flatulence, constipation, diarrhea, and gastric discomfort

✔️ Use in Pregnancy & Lactation

• Use under medical supervision
• Calcium and Vitamin D3 requirements increase during pregnancy and breastfeeding
• Avoid concurrent intake of iron and calcium supplements (separate administration times)
• High-dose Vitamin D3 during pregnancy may cause fetal toxicity in rare cases
• Vitamin D3 and its metabolites can be excreted in breast milk

✔️ Precautions & Warnings

• Monitor serum and urinary calcium levels in long-term use or in renal impairment
• Evaluate calcium excretion in patients with a history of kidney stones
• Be cautious in patients receiving digitalis, due to the increased risk of arrhythmias
• Adjust dosage if taking calcium or vitamin D3 from other sources
• Stop temporarily if urinary calcium > 7.5 mmol/24 hours

✔️ Storage Conditions

• Store in a cool, dry place below 30°C
• Keep away from heat, light, and out of reach of children
• Do not use beyond the expiry date printed on the packaging