Calcichew-D3 Mite Apelsin
Calcium Carbonate 500 mg + Vitamin D3 200 IU – Orange-Flavoured Chewable Tablet
Quick Facts About Calcichew-D3 Mite Apelsin
Key Takeaways About Calcichew-D3 Mite Apelsin
- Dual-action supplement: Provides both calcium (500 mg) and vitamin D3 (200 IU) in a single orange-flavoured chewable tablet, making adherence easier
- Bone health essential: Used for prevention and treatment of calcium and vitamin D deficiency, and as an adjunct to osteoporosis therapy (e.g., with bisphosphonates)
- Timing matters: Take at least 2 hours apart from tetracyclines, bisphosphonates, levothyroxine, and iron supplements to avoid absorption interference
- Monitor calcium levels: Patients with kidney disease or those taking thiazide diuretics should have regular blood calcium monitoring to prevent hypercalcaemia
- Not for everyone: Contraindicated in patients with hypercalcaemia, hypercalciuria, kidney stones, severe kidney impairment, or hypervitaminosis D
What Is Calcichew-D3 Mite Apelsin and What Is It Used For?
Calcichew-D3 Mite Apelsin is a combination chewable tablet that delivers 500 mg of elemental calcium (as calcium carbonate) and 200 IU (5 micrograms) of vitamin D3 (colecalciferol). It is prescribed for the correction of combined calcium and vitamin D deficiency and as a supplement alongside osteoporosis treatment in patients who are at risk of calcium and vitamin D insufficiency.
Calcium and vitamin D are two of the most critical nutrients for maintaining skeletal health throughout life. Calcium is the primary mineral constituent of bone and teeth, providing structural rigidity and serving as a reservoir for the calcium ions required by nearly every cell in the body for muscle contraction, nerve signalling, blood clotting, and enzyme function. Approximately 99% of the body's calcium is stored in the skeleton, and when dietary intake is insufficient, the body draws on this skeletal reserve, gradually weakening bones over time.
Vitamin D3 (colecalciferol) plays an indispensable role in calcium homeostasis. It enhances the intestinal absorption of calcium and phosphate, promotes renal reabsorption of calcium, and supports the mineralization of newly formed osteoid tissue in bone. Without adequate vitamin D, only 10–15% of dietary calcium is absorbed; with sufficient vitamin D levels, absorption increases to 30–40%. This physiological synergy is why calcium and vitamin D are combined in a single tablet: the vitamin D component ensures the body can efficiently utilise the calcium provided.
Calcichew-D3 Mite Apelsin is specifically indicated for the prevention and treatment of vitamin D and calcium deficiency states in older adults, who are particularly vulnerable to insufficiency due to reduced sun exposure, decreased skin synthesis of vitamin D, lower dietary intake, and age-related decline in intestinal absorption efficiency. The “Mite” designation indicates a lower vitamin D content (200 IU) compared to the “Forte” formulation, making it suitable for patients who require moderate vitamin D supplementation or who receive additional vitamin D from other sources.
The orange flavour and chewable format of this medication improve palatability and ease of administration, which is particularly important for elderly patients who may have difficulty swallowing conventional tablets. The tablets should be chewed thoroughly before swallowing, and they can be taken with or after meals. By facilitating adherence, the pleasant taste and convenient dosage form help ensure patients receive consistent daily calcium and vitamin D intake.
Calcichew-D3 Mite Apelsin is used for: (1) Prevention and treatment of calcium and vitamin D deficiency in elderly patients; (2) Calcium and vitamin D supplementation as an adjunct to specific osteoporosis therapy (e.g., bisphosphonates, denosumab, or hormone replacement therapy) in patients at risk of calcium and vitamin D insufficiency.
What Should You Know Before Taking Calcichew-D3 Mite Apelsin?
Before starting Calcichew-D3 Mite Apelsin, inform your doctor about all medical conditions, particularly kidney disease, kidney stones, sarcoidosis, or any condition causing elevated calcium levels. Certain conditions and medications require special precautions or make this supplement unsuitable.
Contraindications
Do not take Calcichew-D3 Mite Apelsin if you have any of the following conditions:
- Hypercalcaemia: Elevated blood calcium levels, which may be caused by hyperparathyroidism, malignancy, excessive vitamin D intake, or other conditions that increase calcium mobilisation from bone
- Hypercalciuria: Excessive calcium excretion in the urine, which increases the risk of kidney stone formation
- Nephrolithiasis: Current calcium-containing kidney stones, as additional calcium supplementation could worsen the condition
- Nephrocalcinosis: Calcium deposits in the kidney tissue, which can impair renal function
- Severe renal impairment: Patients with significantly reduced kidney function (GFR below 30 mL/min) may be unable to properly regulate calcium and phosphate balance
- Hypervitaminosis D: Excessive vitamin D levels in the blood, which can lead to dangerous hypercalcaemia and soft tissue calcification
- Allergy: Known hypersensitivity to calcium carbonate, colecalciferol (vitamin D3), soya, peanut, or any of the excipients
It is essential to have your blood calcium levels checked before starting supplementation if you have a history of any of the above conditions. Your healthcare provider may order a serum calcium test, a 24-hour urine calcium measurement, or renal function tests to ensure it is safe for you to take this medication.
Warnings and Precautions
Talk to your doctor or pharmacist before taking Calcichew-D3 Mite Apelsin if you have any of the following conditions or circumstances:
- Mild to moderate renal impairment: Calcium and vitamin D metabolism is affected by kidney function. Your doctor may need to monitor your blood calcium and phosphate levels more frequently and adjust your dose accordingly
- Sarcoidosis: This granulomatous disease can cause increased conversion of vitamin D to its active form (calcitriol), leading to elevated calcium levels. Use with caution and under close medical supervision
- Immobilisation: Prolonged bed rest or immobility increases the risk of hypercalcaemia because calcium is released from bones that are not bearing weight. Monitor calcium levels closely during periods of reduced mobility
- Concurrent calcium or vitamin D supplementation: If you are already receiving calcium or vitamin D from other supplements, fortified foods, or other medications, your total daily intake must be considered to avoid exceeding recommended limits
- History of kidney stones: Even if you do not currently have stones, a history of calcium nephrolithiasis warrants careful evaluation before starting supplementation. Adequate fluid intake and dietary monitoring are important
During long-term treatment, your doctor should periodically monitor your serum calcium levels and renal function (creatinine clearance), especially if you are also taking thiazide diuretics or cardiac glycosides. This monitoring helps detect early signs of hypercalcaemia, which can manifest as nausea, vomiting, constipation, abdominal pain, excessive thirst, increased urination, muscle weakness, drowsiness, and confusion.
The recommended daily intake of calcium from all sources should generally not exceed 2000–2500 mg, and vitamin D intake should not exceed 4000 IU (100 micrograms) per day in adults, according to international guidelines. Exceeding these limits increases the risk of hypercalcaemia and its associated complications, including vascular calcification and renal damage.
Pregnancy and Breastfeeding
Calcichew-D3 Mite Apelsin can be used during pregnancy when calcium and vitamin D supplementation is clinically indicated. Many pregnant women are at risk of vitamin D insufficiency, and adequate calcium intake is important for foetal skeletal development. However, the total daily intake during pregnancy should not exceed 1500 mg of calcium and 600 IU of vitamin D3.
Excessive doses during pregnancy must be avoided. Prolonged hypercalcaemia during pregnancy has been associated with adverse effects on the developing foetus, including supravalvular aortic stenosis, neonatal hypercalcaemia, and physical and mental retardation. Animal studies have shown teratogenic effects of high-dose vitamin D. Therefore, pregnant women should strictly adhere to the dose recommended by their healthcare provider.
During breastfeeding, calcium and vitamin D3 are excreted into breast milk. This should be considered when calculating the total intake for the infant, particularly if the baby is also receiving vitamin D supplementation. The amount transferred through breast milk is generally insufficient to cause adverse effects in the nursing infant at recommended maternal doses, but your doctor should be informed if you are breastfeeding.
Do not exceed the recommended daily dose. Overdose with calcium and vitamin D can cause hypercalcaemia, which may lead to serious complications including kidney damage, vascular calcification, and cardiac arrhythmias. If you accidentally take more than prescribed, contact your doctor or poison control centre immediately.
How Does Calcichew-D3 Mite Apelsin Interact with Other Drugs?
Calcichew-D3 Mite Apelsin can interact with several important medications. Calcium can significantly reduce the absorption of tetracycline antibiotics, bisphosphonates, levothyroxine, fluoroquinolones, and iron preparations. Thiazide diuretics reduce renal calcium excretion and may increase the risk of hypercalcaemia. Cardiac glycosides require careful monitoring as hypercalcaemia can potentiate digitalis toxicity.
Drug interactions with calcium and vitamin D supplements are primarily of two types: absorption interactions (where calcium physically binds to other drugs in the gastrointestinal tract, reducing their bioavailability) and pharmacodynamic interactions (where the physiological effects of calcium or vitamin D enhance or oppose the effects of other medications). Understanding these interactions is essential for safe and effective use of this supplement.
Calcium carbonate is a divalent cation that forms insoluble chelate complexes with many drugs in the gastrointestinal tract. When calcium binds to another medication, neither substance is properly absorbed, leading to therapeutic failure of the co-administered drug and reduced calcium absorption. The standard clinical solution is temporal separation: taking calcium supplements at least 2 hours before or 4–6 hours after the interacting medication.
Vitamin D3 can also participate in drug interactions through its effects on calcium metabolism. Medications that increase serum calcium (such as thiazide diuretics) may amplify the hypercalcaemic potential of vitamin D supplementation. Conversely, drugs that alter vitamin D metabolism (such as certain anticonvulsants and corticosteroids) may reduce the effectiveness of the supplement.
Major Interactions
| Drug / Drug Class | Type of Interaction | Clinical Effect | Recommendation |
|---|---|---|---|
| Tetracycline antibiotics | Absorption (chelation) | Reduced tetracycline absorption by up to 65% | Take tetracycline at least 2 hours before or 4–6 hours after calcium |
| Bisphosphonates (alendronate, risedronate) | Absorption (chelation) | Significantly reduced bisphosphonate absorption | Take bisphosphonate at least 30 min before calcium; ideally 2 hours apart |
| Levothyroxine | Absorption (chelation) | Reduced levothyroxine absorption, potentially causing hypothyroidism | Take levothyroxine at least 4 hours before calcium |
| Cardiac glycosides (digoxin) | Pharmacodynamic | Hypercalcaemia increases risk of digitalis toxicity and arrhythmias | Monitor ECG and serum calcium regularly |
| Thiazide diuretics | Pharmacodynamic | Reduced renal calcium excretion; increased hypercalcaemia risk | Monitor serum calcium levels regularly |
| Iron supplements | Absorption (chelation) | Reduced iron absorption | Take at least 2 hours apart |
| Fluoroquinolone antibiotics | Absorption (chelation) | Reduced fluoroquinolone absorption | Take fluoroquinolone at least 2 hours before or 6 hours after calcium |
| Corticosteroids | Pharmacodynamic | Reduced calcium absorption and increased calcium excretion | Higher calcium and vitamin D doses may be needed; consult doctor |
| Anticonvulsants (phenytoin, carbamazepine) | Pharmacokinetic | Increased vitamin D metabolism; reduced effectiveness | May need higher vitamin D doses; monitor 25(OH)D levels |
The table above is not exhaustive. Always carry a complete list of all your medications (including over-the-counter products, vitamins, and dietary supplements) and share it with every healthcare provider you visit. This is especially important with calcium supplements, as the chelation interactions affect a wide range of commonly prescribed medications.
Certain dietary components can affect calcium absorption. Oxalic acid (found in spinach, rhubarb, and chocolate) and phytic acid (found in whole grains and beans) can form insoluble complexes with calcium, reducing its absorption. However, these foods do not need to be avoided entirely; simply ensure your calcium tablet is not taken at the same time as a meal very high in these substances. Caffeine has a modest diuretic effect that may slightly increase calcium excretion, but moderate coffee consumption (2–3 cups daily) does not significantly impact calcium balance when dietary intake is adequate.
What Is the Correct Dosage of Calcichew-D3 Mite Apelsin?
The usual adult dose is 1 to 2 chewable tablets per day, providing 500–1000 mg of calcium and 200–400 IU of vitamin D3. Tablets should be chewed before swallowing and can be taken with or after meals. Your doctor will determine the exact dose based on your individual needs, dietary intake, and medical condition.
The correct dosage of Calcichew-D3 Mite Apelsin depends on the clinical indication, the patient's existing dietary calcium and vitamin D intake, serum 25-hydroxyvitamin D levels, and the presence of any conditions or medications that affect calcium or vitamin D metabolism. The goal of supplementation is to achieve and maintain total daily calcium intake within the recommended range (typically 1000–1200 mg for adults over 50) without exceeding safe upper limits.
Adults
Standard Adult Dose
1 to 2 tablets daily (providing 500–1000 mg calcium and 200–400 IU vitamin D3). The tablets should be chewed thoroughly before swallowing. They may be taken with or after a meal. If taking 2 tablets daily, it is preferable to split the dose (one tablet morning, one tablet evening) to optimise absorption, as the body absorbs calcium more efficiently in smaller doses.
For patients using Calcichew-D3 Mite Apelsin as an adjunct to bisphosphonate therapy for osteoporosis, the calcium supplement should be taken at a different time from the bisphosphonate to avoid interference with absorption. Most bisphosphonates (e.g., alendronate) should be taken first thing in the morning on an empty stomach, with the calcium supplement taken later in the day.
Children and Adolescents
Paediatric Dosing
Calcichew-D3 Mite Apelsin is generally intended for adult use. Use in children and adolescents should only be on the specific advice of a healthcare provider. The dose will be determined individually based on the child's age, weight, calcium requirements, and clinical condition. Children under 6 years of age should not use chewable tablets unless instructed by a doctor due to choking risk.
Elderly Patients
Geriatric Dosing
1 to 2 tablets daily, the same as for adults. Elderly patients are the primary target population for this supplement. However, renal function declines with age, and elderly patients with reduced kidney function may require closer monitoring of serum calcium and renal parameters. No specific dose adjustment is typically required for age alone, but the overall calcium and vitamin D intake from all sources should be assessed.
Missed Dose
If you forget to take a dose of Calcichew-D3 Mite Apelsin, take it as soon as you remember, unless it is nearly time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a forgotten tablet. Missing an occasional dose of a calcium and vitamin D supplement is unlikely to have significant clinical consequences, as the body maintains calcium stores in bone. However, consistent daily supplementation provides the greatest benefit for bone health.
Overdose
Overdose with Calcichew-D3 Mite Apelsin can lead to hypervitaminosis D and hypercalcaemia. Symptoms of calcium and vitamin D overdose include severe nausea, vomiting, excessive thirst (polydipsia), increased urination (polyuria), constipation, abdominal pain, muscle weakness, fatigue, mental confusion, and in severe cases, cardiac arrhythmias, coma, and renal failure.
Chronic excessive intake (more than 2500 mg calcium and/or more than 4000 IU vitamin D daily for prolonged periods) can lead to vascular and soft tissue calcification, kidney damage, and kidney stones. If you suspect an overdose, stop taking the medication immediately and seek medical attention. Treatment typically involves stopping all calcium and vitamin D supplementation, IV fluid resuscitation, and in severe cases, loop diuretics (furosemide) to enhance renal calcium excretion. Blood calcium, phosphate, and renal function should be monitored closely.
Seek immediate medical attention if you experience severe nausea, vomiting, extreme thirst, confusion, muscle weakness, or irregular heartbeat after taking excessive amounts of calcium and vitamin D. Bring the medication packaging with you to the hospital.
What Are the Side Effects of Calcichew-D3 Mite Apelsin?
The most common side effects are gastrointestinal disturbances including constipation, flatulence, nausea, abdominal pain, and diarrhoea. Uncommon side effects include hypercalcaemia and hypercalciuria. Allergic reactions are rare but possible. Most side effects are mild and often resolve with continued use or dose adjustment.
Like all medications, Calcichew-D3 Mite Apelsin can cause side effects, although not everybody gets them. Calcium supplements are generally well tolerated, and most adverse effects are related to the gastrointestinal effects of calcium carbonate. The following frequency classification is based on clinical trial data and post-marketing surveillance reports, using standard medical frequency categories.
The gastrointestinal side effects of calcium carbonate are largely due to its antacid properties and its effect on gut motility. Calcium ions stimulate gastrin release and can increase gastric acid secretion via a rebound mechanism. Calcium carbonate also releases carbon dioxide in the stomach when it reacts with hydrochloric acid, which can cause bloating and flatulence. Constipation is the most frequently reported side effect and is related to calcium's effect on smooth muscle tone in the colon.
Common (affects 1–10 in 100 people)
- Constipation
- Flatulence (bloating and gas)
- Nausea
- Abdominal pain or discomfort
- Diarrhoea
- Dyspepsia (indigestion)
Uncommon (affects 1–10 in 1,000 people)
- Hypercalcaemia (elevated blood calcium levels)
- Hypercalciuria (elevated calcium in urine)
- Skin rash or itching (pruritus)
- Urticaria (hives)
Rare (affects fewer than 1 in 1,000 people)
- Angioedema (swelling of face, lips, tongue, or throat)
- Anaphylactic reaction (severe allergic reaction)
- Milk-alkali syndrome (with prolonged high-dose use: hypercalcaemia, metabolic alkalosis, renal impairment)
If you experience any persistent or troublesome side effects, speak with your doctor or pharmacist. Gastrointestinal symptoms such as constipation can often be managed by increasing fluid and fibre intake, or by taking the supplement with meals. If hypercalcaemia is suspected (symptoms include excessive thirst, frequent urination, nausea, confusion, or muscle weakness), your doctor will check your blood calcium levels and may adjust or discontinue the supplement.
Patients with a known allergy to soya or peanut should be aware that some formulations of Calcichew-D3 may contain soya-derived excipients. Check the specific product information or consult your pharmacist if you have these allergies. If you experience any signs of a serious allergic reaction (difficulty breathing, swelling of the face or throat, severe skin rash), stop taking the medication and seek emergency medical attention immediately.
You can help improve medication safety by reporting any side effects to your national pharmacovigilance agency. In the EU, report to your national competent authority. In the US, report to the FDA MedWatch programme. In the UK, report via the Yellow Card Scheme. Your reports contribute to the ongoing monitoring of the benefit-risk balance of medications.
How Should You Store Calcichew-D3 Mite Apelsin?
Store Calcichew-D3 Mite Apelsin below 30°C in the original container to protect from moisture. Keep the container tightly closed. Do not use after the expiry date printed on the packaging. Keep out of the sight and reach of children.
Proper storage of Calcichew-D3 Mite Apelsin is important to maintain the quality and effectiveness of the medication throughout its shelf life. Vitamin D3 (colecalciferol) is sensitive to light, heat, and moisture, and can degrade if exposed to unfavourable storage conditions. Calcium carbonate is more stable but can absorb moisture from the environment, which may affect the tablet's chewability and taste.
Store the tablets at a temperature below 30°C (86°F). Do not store in the refrigerator or freezer. Keep the container tightly closed between uses to protect the tablets from humidity. Do not transfer the tablets to another container unless the new container provides equivalent protection from light and moisture. The original packaging is specifically designed to maintain product quality.
Check the expiry date on the packaging before each use. Do not take Calcichew-D3 Mite Apelsin after the expiry date, which refers to the last day of the month stated on the package. Expired calcium and vitamin D tablets may have reduced potency, particularly regarding the vitamin D component, and should be discarded appropriately.
Do not dispose of medications via wastewater or household waste. Return unused or expired tablets to your pharmacy for proper disposal according to local regulations. This helps protect the environment and prevents accidental ingestion by children or animals.
What Does Calcichew-D3 Mite Apelsin Contain?
Each chewable tablet contains calcium carbonate (equivalent to 500 mg elemental calcium) and colecalciferol (vitamin D3) 200 IU (5 micrograms) as active ingredients. Excipients include sorbitol, povidone, isomalt, magnesium stearate, fatty acid mono- and diglycerides, orange flavouring, and other tabletting agents.
The active ingredients in Calcichew-D3 Mite Apelsin are:
- Calcium carbonate: 1250 mg per tablet, equivalent to 500 mg of elemental calcium (the actual amount of calcium available for absorption). Calcium carbonate is the most concentrated form of supplemental calcium, containing 40% elemental calcium by weight. It is best absorbed when taken with food, as gastric acid enhances the dissolution of calcium carbonate
- Colecalciferol (vitamin D3): 200 IU (5 micrograms) per tablet. Colecalciferol is the natural form of vitamin D produced in the skin upon exposure to ultraviolet B (UVB) radiation. It is the preferred form for supplementation because of its greater potency and longer duration of action compared to ergocalciferol (vitamin D2)
The excipients (inactive ingredients) serve various pharmaceutical functions including tablet binding, flavouring, sweetening, lubrication, and stability enhancement. The orange flavouring gives the tablet its characteristic taste, improving patient compliance. Sorbitol is used as a sweetener; patients with rare hereditary fructose intolerance should not take this medication. Isomalt is also used as a sweetener and may have a mild laxative effect in sensitive individuals.
The vitamin D3 component is typically prepared as a concentrate that includes protective excipients such as alpha-tocopherol (vitamin E, as an antioxidant), modified starch, sucrose, and medium-chain triglycerides. These substances protect the vitamin D3 from degradation and ensure uniform distribution within the tablet. Some formulations may contain soya-derived components; patients with soya or peanut allergy should check the specific product information carefully.
It is important to distinguish between the weight of calcium carbonate (1250 mg per tablet) and the amount of elemental calcium it provides (500 mg). The elemental calcium is the clinically relevant figure – it is the actual amount of calcium your body can absorb and use. When comparing different calcium supplements, always compare elemental calcium content. Other calcium salts (e.g., calcium citrate at 21% elemental calcium) provide different amounts of elemental calcium per gram of salt.
Frequently Asked Questions About Calcichew-D3 Mite Apelsin
Calcichew-D3 Mite Apelsin is a combination chewable tablet used to prevent and treat calcium and vitamin D deficiency, particularly in elderly patients. It provides 500 mg of calcium and 200 IU of vitamin D3 per tablet. It is also widely prescribed as a supplement alongside osteoporosis treatments such as bisphosphonates, denosumab, or hormone replacement therapy. The orange-flavoured chewable format makes it easy to take and improves adherence to daily supplementation.
Yes, but timing is crucial. Calcium can bind to and reduce the absorption of many medications. You should take Calcichew-D3 Mite Apelsin at least 2 hours apart from tetracycline antibiotics, fluoroquinolones, bisphosphonates, levothyroxine, and iron supplements. If you are taking digoxin or thiazide diuretics, your doctor should monitor your blood calcium levels regularly. Always tell your doctor and pharmacist about all medications and supplements you are taking.
The usual dose for adults is 1 to 2 tablets per day. Your doctor will determine the exact dose based on your individual needs and dietary calcium intake. If taking 2 tablets daily, it is best to split the dose (one in the morning, one in the evening) for better absorption. Chew the tablet thoroughly before swallowing. Do not exceed the dose recommended by your healthcare provider.
Calcichew-D3 Mite Apelsin can be used during pregnancy when calcium and vitamin D supplementation is medically recommended. However, the total daily intake should not exceed 1500 mg calcium and 600 IU vitamin D3 during pregnancy. Excessive doses of vitamin D during pregnancy can cause foetal harm, including neonatal hypercalcaemia. Always consult your doctor before starting or continuing any supplements during pregnancy or breastfeeding.
The most commonly reported side effects are gastrointestinal: constipation, flatulence (gas and bloating), nausea, abdominal discomfort, and diarrhoea. These effects are usually mild and often improve over time. Increasing fluid and fibre intake can help with constipation. Less commonly, elevated blood calcium (hypercalcaemia) or elevated urine calcium (hypercalciuria) may occur, particularly if the recommended dose is exceeded. Contact your doctor if side effects persist or worsen.
Both products contain 500 mg of elemental calcium per tablet, but they differ in vitamin D3 content. Calcichew-D3 Mite contains 200 IU (5 micrograms) of vitamin D3, while Calcichew-D3 Forte contains 400 IU (10 micrograms) or more. Your doctor will select the appropriate formulation based on your vitamin D status, total daily intake from all sources, and clinical requirements. The Mite (lower dose) version is suitable for patients who need moderate supplementation or who already receive vitamin D from other sources.
References and Sources
This article is based on the following peer-reviewed sources and international clinical guidelines:
- European Medicines Agency (EMA). Summary of Product Characteristics: Calcium carbonate/Colecalciferol combination products. Available at: www.ema.europa.eu
- World Health Organization (WHO). WHO Model List of Essential Medicines, 23rd List (2023). Calcium and vitamin D listed as essential supplements. Available at: www.who.int
- Weaver CM, Alexander DD, Boushey CJ, et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporosis International. 2016;27(1):367–376. doi:10.1007/s00198-015-3386-5
- Bolland MJ, Leung W, Tai V, et al. Calcium intake and risk of fracture: systematic review. BMJ. 2015;351:h4580. doi:10.1136/bmj.h4580
- Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press; 2011.
- Lips P, Cashman KD, Lamberg-Allardt C, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. European Journal of Endocrinology. 2019;180(4):P23–P54. doi:10.1530/EJE-18-0736
- British National Formulary (BNF). Calcium carbonate with colecalciferol monograph. Available at: bnf.nice.org.uk
- Kanis JA, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International. 2019;30(1):3–44. doi:10.1007/s00198-018-4704-5
- Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266–281. doi:10.1056/NEJMra070553
- National Osteoporosis Foundation (NOF). Clinician's Guide to Prevention and Treatment of Osteoporosis. 2014 (updated 2022).
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in clinical pharmacology, endocrinology, and bone metabolism.
iMedic Medical Editorial Team – Specialists in Clinical Pharmacology and Endocrinology. All content follows the GRADE evidence framework and is based on systematic reviews, meta-analyses, and international clinical guidelines.
iMedic Medical Review Board – Independent panel of medical experts who verify clinical accuracy, ensure guideline adherence (EMA, WHO, NICE), and confirm that all information is current and evidence-based.
Our editorial process ensures all medication information is accurate, balanced, and free from commercial influence. We declare no conflicts of interest and accept no pharmaceutical industry funding. Content is updated whenever new significant evidence or guideline changes emerge.