GEMCROS PLUS CAP(B/L)

• Calcitriol is the fully active form of vitamin D, requiring no activation by the liver or kidney — the reason it works where ordinary vitamin D does not.
• That makes it the appropriate choice in chronic kidney disease, where the kidney can no longer activate vitamin D.
• Calcium provides the mineral substrate for bone formation.
• Zinc is a cofactor in bone matrix formation and in the enzymes of bone turnover.
• Calcitriol directly increases intestinal calcium absorption, so the calcium given is used rather than excreted.

Not everyone gets these. Most are mild and settle as the course finishes.

• Calcitriol is far more potent than ordinary vitamin D and has a narrow margin between effective and toxic. Serum calcium must be monitored regularly during treatment.
• Do not substitute calcitriol dose-for-dose with cholecalciferol or vice versa — they are not interchangeable.
• Contraindicated in hypercalcaemia, hypervitaminosis D, and in a history of calcium-containing kidney stones.
• Do not take another vitamin D or calcium preparation alongside without checking the total.
• Take with food. Calcium carbonate needs gastric acid for absorption and is poorly absorbed on an empty stomach.
• Separate from tetracycline and fluoroquinolone antibiotics, thyroid hormone, iron and bisphosphonates by at least two to four hours.
• Use with particular caution alongside thiazide diuretics and digoxin, where raised calcium is more dangerous.
• Maintain adequate fluid intake, and report early symptoms of hypercalcaemia promptly.