Calcium is an essential element and plays vital roles in the body. It

Each tablet contains Calcium carbonate 1250 mg (equivalent to 500 mg
of elemental Calcium) and Vitamin D3 200 IU (equivalent to 5 mcg of
Cholecalciferol).

1. Treatment of osteoporosis, rickets, osteomalacia and tetany.
2. As supplement during pregnancy and lactation.
3. For prevention and treatment of Calcium and Vitamin D deficiency.

Adults and children above 12 years of age: 2 tablets per day,
preferably one tablet each morning and one at evening with a full
glass of water.

Absolute contraindications are hypercalcaemia, primary hyperparathyroidism, kidney stone, severe renal failure, Calcium and Vitamin D overdosage, hypersensitivity to any of the tablet ingredients. Relative contraindications are osteoporosis due to prolonged immobilization, renal stones, and severe hypercalciuria.

Patients with mild to moderate renal failure or mild hypercalciuria should be supervised carefully. In patients with a history of renal stones urinary calcium excretion should be measured to exclude hypercalciuria. With long-term treatment it is advisable to monitor serum and urinary calcium levels and kidney function, and reduce or stop treatment temporarily if
urinary calcium exceeds 7.5 mmol/24 hours.

Maxical can be safely used during pregnancy and lactation, as Calcium
and Vitamin D requirements are increased in these cases. However,
you should only use this medicine after consulting your doctor.

The risk of hypercalcaemia should be considered in patients taking
Thiazide diuretics. Concomitant treatment with Phenytoin or Barbiturates can decrease the effect of Vitamin D because of metabolic activation. Concomitant use of Glucocorticoids can decrease the effect of Vitamin D. The effects of Digitalis and other Cardiac glycosides may be accentuated with the oral administration of Calcium combined with Vitamin D. Calcium salts may reduce the absorption of Thyroxin, Sodium fluoride, Quinolone or Tetracycline antibiotics or Iron. It is advisable to allow a minimum period of four hours taking the Calcium products.

The use of Calcium supplements has rarely given rise to mild gastrointestinal disturbances, such as constipation, flatulence, nausea,
gastric pain, diarrhea. Following administration of Vitamin D supplements occasional skin rash has been reported. Hypercalciuria, and in rare cases hypercalcaemia have been seen with long-term treatment at high doses.

The most serious consequence of acute or chronic overdose is
hypercalcaemia due to Vitamin D toxicity. Symptoms include nausea,
vomiting, and constipation. Chronic overdosage can lead to vascular
and organ calcification as a result of hypercalcaemia. Treatment
should consist of stopping intake of the drug and rehydration.

Store in a cool and dry place, away from light.

Plastic bottle contains 15 tablets and 30 tablets.