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.
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. Shelcal should be used with caution in patients suffering from tiny collections of inflammatory cells.
High Calcium Level
There is a risk of a high calcium
level. Caution should be taken when Shelcal is taken by paralyzed patients with low bone mass and rupture of bone tissue. The content of vitamin
D in Shelcal 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.
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
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.