Actical^®

Actical is a combination of Calcium Citrate Tetrahydrate and Calcitriol. Calcium is absorbed from the GI tract which requires vitamin D. It readily enters extracellular fluid.
It is excreted mostly in the feces; 20% eliminated by the kidneys. As an active form of vitamin D 3 , Calcitriol elevates the plasma levels of Calcium by stimulating intestinal
Calcium uptake, increasing reabsorption of Calcium by the kidneys and possibly increasing the release of Calcium from skeletal stores. The duration of pharmacologic
activity of a single dose of exogenous Calcitriol is expected to be about 3 to 5 days.

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Actical is used to prevent or treat low blood calcium levels in people who do not get enough calcium from their diets. It may be used to treat conditions caused by low calcium levels such as bone loss (osteoporosis), weak bones (osteomalacia, rickets), decreased activity of the parathyroid gland (hypoparathyroidism) and a certain muscle disease (latent tetany). It may also be used in certain patients to make sure they are getting enough calcium (e.g. postmenopausal)

Route of administration: Actical® should be taken in oral route with or without food.
1- 4 tablets daily depending on clinical situation or as directed by the registered
physician

Use in pregnancy and lactation
Calcium crosses the placenta and enters breast milk. This combination should be used
as directed by the registered physician during pregnancy and lactation.

Use in children and adolescents
Caution should be taken when it is administered to a child

This combination should be used with cautions in the conditions such as, hypercalcemia, malabsorption syndrome, heart disease, kidney disease, kidney stones,
certain immune system disorder (Sarcoidosis), liver disease and certain bowel diseases (Crohn's disease).

The most common side effects are constipation, nausea, abdominal pain, headache, hypercalcemia, hypercalciuria and muscle weakness

This combination is contraindicated in patients with known hypersensitivity to calcium citrate and calcitriol or any other components of this product. It is also contraindicated
for the patients with hypercalcemia,hypercalciuria and hypophosphatemia

Drug interaction with medication: Reduced absorption of tetracyclines, quinolones and oral biphosphates with concurrent calcium use. Calcium absorption may be
reduced by corticosteroids. Increased risk of hypercalcemia and metabolic alkalosis with thiazide diuretics. High blood calcium level may increase the effect of cardiac
glycosides. Reduced erlotinib efficacy with calcium. Increased risk of hypercalcemia with paricalcitol. Enzyme inducing antiepileptics increases the metabolism of vitamin D.
Fatal encephalopathy can occur in patients with renal failure when given calcium citrate and aluminium products concurrently due to marked rise in aluminium levels

Assess patient for nausea, vomiting, anorexia, thirst, severe constipation, paralytic ileus and bradycardia. Immediate treatment should be given if these signs of hypercalcemia
occur.

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Each coated tablet contains Calcium Citrate Tetrahydrate USP 1200 mg equivalent to 252 mg Calcium and Calcitriol BP 0.25 mcg

Storage
Store in a cool (below 25⁰C) & dry place protected from light. Keep away from the reach of children.

Packing
Actical ® tablet: Carton of 30 tablets in blister packx contains 32 capsules in blister pack.