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Maxical Tablet

Generic Name(s): Calcium Carbonate, Vitamin D3

Why it's used

Maxical Tablet is used to prevent & treat vitamin D and calcium deficiency in the elderly. This medicine works by slowing down the process of old bone growth, which provides the bone-forming cells time to reconstruct a healthy bone. This medicine helps to maintain the bone structure. Maxical is also used to treat osteoporosis patients who are at risk of vitamin D and calcium deficiency.
Antacid
Maxical belongs to a class of medicines called Antacid. Antacid.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Maxical. Eat this medicine as per your doctor's instructions.
Maxical is eaten with or without food. Swallow whole tablet with a glass of water. Maxical is eaten It should be taken just after getting up in the morning and before taking the first meal. Avoid taking it at bedtime.

Typical Dosage

The typical adult dose of Maxical is 1000 mg of calcium/8.8 mg of cholecalciferol once daily. There are no known habit-forming tendencies with this medicine.
Maxical is to be used for longer periods of time.
If you are using the chewable tablet form of this medicine, make sure you chew the medicine before you swallow it.

Talk to Your Doctor

Tell your doctor if you develop new symptoms. Talk to your doctor if difficulty or pain on swallowing, heartburn, and chest pain.

Use in Children

The safety and effectiveness of using this medicine in children has not been established. This medicine should not be used in children because it contains a large amount of vitamin D.

Limit Alcohol

Avoid Food and mineral water including other drinks, such as juices, tea, and coffee while using Maxical. These will reduce the effect of Maxical by preventing the absorption of Maxical into the body. Limit drinking alcohol with Maxical.

Storage

Store Maxical Tablet below 25°C, away from moisture, and away from light. Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Maxical Tablet for symptoms for which it was not prescribed. Do not give Maxical Tablet to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Maxical

Your dose and how often you take Maxical will depend on the following factors:

Maxical Dosage

Dosage for vitamin D and calcium deficiency

Adult
  • Recommended: one chewable tablet daily (1000 mg of calcium/8.8 mg of colecalciferol)

Forms

Chewable Tablet
Strength: One chewable tablet (1000 mg of calcium / 8.8mg of colecalciferol)

Missed Dose

Take the missed dose on the morning after you remember. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Maxical?
In the case of high calcium level, the therapy with Maxical, thiazide diuretics, lithium, cardiac glycosides, and vitamin A should be discontinued. Emptying of the stomach is preferred in patients with decreased consciousness. Blood electrolytes, functioning of the kidneys, and excessive production of urine must be monitored. In severe cases, electrocardiography and central venous pressure, near the right atrium of the heart should be followed.
Symptoms of an overdose of Maxical
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Maxical Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Maxical

Before you use Maxical, tell your doctor of your medical and health history including the following:
  • dental or jaw-bone problems
  • food pipe disorders
  • high blood calcium
  • kidney disease
  • kidney stone
  • low blood calcium
  • smoker
  • swallowing or digestive problems (for example, ulcers)
  • unable to sit or stand upright for a minimum of 30 minutes
In some cases, Maxical can burn and irritate the food pipe.
Before you use Maxical, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Maxical Tablet may change electrocardiogram. ECG is required to monitor during Maxical is given to the patients.
The use of this medicine may change blood phosphate level. Maxical may increase the blood phosphate level. The monitoring of the blood phosphate level is necessary.
The use of Maxical Tablet may change blood calcium level. Maxical may increase the blood calcium level. The monitoring of blood calcium level is necessary.

Use when Pregnant

Maxical is known to be safe for use in pregnant women. Pregnant women should not use a daily dose of more than 1500 mg calcium and 600 I.U. vitamin D3. The overdose of calcium and vitamin D may result in high blood calcium level and this may be associated with abnormality of physical and mental development, a heart defect and damage to the retina of eyes (retinopathy).

If Breastfeeding

Maxical Tablet is known to be safe for use in women who are breastfeeding. This medicine may pass into the breastmilk. It can be used while providing extra vitamin D to the child.

If trying to Conceive

Consult with your doctor on the use of Maxical, if you are trying to conceive.

Alcohol

Limit drinking alcohol with Maxical. Consumption of alcohol may cause bone weakness (osteoporosis).

Dizziness

Maxical can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Maxical can worsen the sleepiness.

Increase in Risk

This medicine may increase your sensitivity to sunlight and make you prone to sunburn. If this happens, limit your time outdoors to prevent sunburn. Use a sunscreen and cover your skin.

What precautions should be taken during Pregnancy and Nursing, and administering Maxical to Children or the Older Adults?

Pregnant Women

Possibly safe
Warning: Pregnant women should not use a daily dose of more than 1500 mg calcium and 600 I.U. vitamin D3. The overdose of calcium and vitamin D may result in high blood calcium level and this may be associated with abnormality of physical and mental development, a heart defect and damage to the retina of eyes (retinopathy).

Breastfeeding

Possibly safe
Warning: This medicine may pass into the breastmilk. It can be used while providing extra vitamin D to the child.

Younger Adults Population

Contraindicated or Not Recommended
Warning: This medicine should not be used in children because it contains a large amount of vitamin D.

Older Adults Population

Possibly safe
Warning: 

Maxical Side-effects

The following side-effects may commonly occur when using Maxical Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Maxical Tablet may cause the following side-effects:
  • accumulation of calcium in kidneys (nephrocalcinosis)
  • black or bloody stools
  • chest pain
  • difficulty in passing urine
  • eye pain or redness
  • gas formation (flatulence)
  • hives
  • increased abdominal pressure (abdominal distension)
  • increased excretion of calcium in the urine (hypercalciuria)
  • infection
  • itching
  • muscle cramps
  • muscle spasms
  • pain in the hip or thigh
  • prolonged healing after a tooth extraction
  • swelling of the face, throat, lips, mouth, or tongue
  • tingling sensation around the mouth or fingers
  • toothache
The following severe side-effects may also occur when using Maxical Tablet:
  • Metabolism and nutrition disorders
    Symptoms: increased blood calcium level (hypercalcaemia) increased blood phosphate level (hyperphosphataemia)
  • Kidney disorders
    Symptoms: kidney stone (nephrolithiasis) symptoms such as severe lower back or abdominal pain
  • Symptoms: difficulty in breathing
    The use of this medicine should be discontinued and tell your doctor right away.
  • Immune system disorders
    Symptoms: severe allergic reactions, swelling due to fluid accumulation swelling of the throat
    If this happens, stop using this medicine and contact your doctor immediately.
  • Stomach and intestinal disorders
    If this happens, tell your doctor immediately.
  • Eye disorder
    Symptoms: blurred vision
    If this happens, tell your doctor immediately.
  • Difficulty in swallowing
    If this happens, stop using this medicine and contact your doctor immediately.
Your doctor has prescribed Maxical Tablet because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Maxical Tablet.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Maxical by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:
  • black or bloody stools
  • chest pain
  • difficulty in passing urine
  • eye pain or redness
  • flatulence
  • hives
  • hypercalciuria
  • increased abdominal distension
  • infection
  • itching
  • muscle cramps
  • muscle spasms
  • nephrocalcinosis
  • pain in the hip or thigh
  • prolonged healing after a tooth extraction
  • swelling of the face, throat, lips, mouth, or tongue
  • tingling sensation around the mouth or in the fingers
  • toothache

Severe Side-effects

Following are the severe side-effects of this medicine:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:
  • swelling of the face

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • difficulty in breathing
  • difficulty in swallowing
  • rash
  • severe skin reaction
  • swelling due to fluid accumulation
  • swelling of the larynx
  • swelling of the mouth, lips, throat or tongue
If this happens, stop using this medicine and contact your doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Family History Related Problems

Patients with rare family history problems of improper glucose-galactose absorption, abnormal fructose absorption, or deficiency of sucrase and isomaltase should not take this medicine.

Tetracyclines or Quinolones

Combined use with tetracyclines or quinolones is not usually recommended. If it is given, it should be used with caution. Tetracyclines or Quinolone antibiotics should be taken before two hours or after six hours of calcium intake.

High Calcium Level

There is a risk of a high calcium level. Caution should be taken when Maxical is taken by paralyzed patients with low bone mass and rupture of bone tissue. The content of vitamin D in Maxical should be considered when prescribing other therapeutic products comprising vitamin D. Use of additional doses of vitamin D or calcium should be taken under close medical supervision. In such cases, it is advised to often monitor urinary calcium excretion and blood calcium levels.

Tiny Collections of Inflammatory Cells (Sarcoidosis)

There is a risk of increased digestion and the transport of vitamin D into its active form. These patients should be monitored about the calcium content in the blood and urine. Maxical should be used with caution in patients suffering from tiny collections of inflammatory cells.

Kidney Problems

Patients who are on combined therapy with thiazide diuretics or cardiac glycosides and in patients with a high tendency to the dental plaque are at a higher risk. There is a risk of buildup of calcium in the soft tissues. In patients with poor function of the kidneys, other forms of vitamin D should be used. During long-term treatment, blood calcium levels should be followed, and the functioning of kidneys should be monitored through estimations of blood creatinine. Dose reduction or discontinuation of the therapy should be preferred in case of high calcium level or signs of damaged functioning of the kidneys. Use Vitamin D with caution in patients with damaged functioning of the kidneys and the effect on phosphate and calcium levels should be monitored.

Interactions with Maxical

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Maxical Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Antiseizure Drugs

Maxical Tablet interacts with Phenytoin or Barbiturates, which are used to treat seizures and anxiety and insomnia respectively. Combined therapy with barbiturates or phenytoin can reduce the effect of vitamin D.

Corticosteroids

There may be an interaction of Maxical with Corticosteroids, which are used to treat inflammatory conditions. Natural steroids reduce calcium absorption and the effect of vitamin D may get reduced. On combined use, it is necessary to increase the dose of Maxical.

Thiazide Diuretics

Maxical Tablet may interact with thiazide diuretics, which are used to treat high blood pressure. Thiazide diuretics reduce the elimination of metabolic waste of calcium. There is a risk of a high level of calcium. Blood calcium should be monitored regularly during the combined use of thiazide diuretics.

Oxalic Acid and Phytic Acid

Your doctor's guidelines may need to be followed while taking this medicine along with oxalic acid, which is used as a bleach for wood, removing black stains and phytic acid, which is used as an antioxidant. Oxalic acid and phytic acid may block calcium absorption through formation of compounds which are insoluble with calcium ions. The patient should avoid calcium products within two hours of having meals high in phytic acid (found in whole cereals) and oxalic acid (found in spinach and rhubarb).

Ion Exchange Resins

Special instructions need to be followed while taking this medicine along with ion exchange resins, which are used in different separation, purification, and decontamination processes. Combined treatment with ion exchange resins including cholestyramine or laxatives such as paraffin oil may lessen the stomach and intestinal absorption of vitamin D. A time interval between the intakes is suggested.

Cardiac Glycosides

Your doctor's guidelines may need to be followed while taking this medicine along with cardiac glycosides, which are used for treating heart failure and certain irregular heartbeats. High level of calcium may increase the side effects of cardiac glycosides during treatment with Maxical. Patients should be monitored for electrical activity in the heart and blood calcium levels.

Quinolone Antibiotics

Special instructions need to be followed while taking this medicine along with quinolone antibiotics, which are used to treat illnesses such as respiratory and urinary tract infections. The absorption of quinolone antibiotics may be affected if it is used in combination with calcium. It is advised to take quinolone antibiotics two hours before or after six hours of calcium intake.

Levothyroxine

Maxical Tablet interacts with levothyroxine, which is used to treat thyroid hormone deficiency. The effectiveness of levothyroxine can be lessened by the combined use of calcium, due to decreased levothyroxine absorption. There should be at least four hours interval between the use of calcium and levothyroxine.

Bisphosphonate or Sodium Fluoride

There may be an interaction of Maxical with bisphosphonate, which is used to prevent the loss of bone density or sodium fluoride, which is used to prevent cavities. It is recommended to take one tablet daily since the stomach and intestinal absorption may get decreased. If sodium fluoride or bisphosphonate is used with Maxical, it should be used at least three hours before Maxical intake.

Tetracycline Preparations

Maxical Tablet may interact with tetracycline preparations, which is used to treat bacterial infections. Calcium carbonate may prevent the absorption of drugs used in combination with tetracycline preparations. Tetracycline preparations should be given before two hours or after four to six hours of calcium intake.

Interactions of Maxical by Severity

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Maxical be not used?

Allergy

This medicine should not be used in patients with a known allergic reaction to it. These patients suffer from severe skin reactions. These patients may have the following symptoms if they use this medicine:
  • rash
  • swelling due to fluid accumulation
  • swelling of the mouth, face, lips, throat or tongue
  • difficulty in breathing
  • difficulty in swallowing

Hypercalciuria and Hypercalcemia

This medicine should not be used in patients suffering from increased excretion of calcium in the urine and increased blood calcium level or diseases which may cause such conditions (for example, bone metastases, myeloma, primary hyperparathyroidism, prolonged immobilization).

Kidney Stones

This medicine should not be used in patients with kidney stones (nephrolithiasis).

Accumulation of Calcium in Kidneys

This medicine should not be used in patients with an accumulation of calcium in the kidneys (nephrocalcinosis).

Hypervitaminosis D

This medicine should not be used in patients with an increased level of vitamin D in the blood.

Severe Kidney Dysfunction

This medicine should not be used in patients having severe kidney dysfunction.

Use in Children

This medicine should not be used in children because it contains a large amount of vitamin D.

Expired Medication

Taking a single dose of expired Maxical is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Maxical Tablet .

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