Nescal DX 600 mg + 400 iu Tablet

Nescal DX 600 mg + 400 iu tablet by National Drug Company Ltd. is a calcium and vitamin D supplement that contains Calcium + Cholecalciferol (Vit. D3). In Bangladesh, it is commonly used to prevent or treat calcium and vitamin D deficiency and as supportive therapy in conditions such as osteoporosis when advised by a healthcare professional.

Calcium + Cholecalciferol (Vit. D3) helps supply calcium for bones, teeth, muscles and nerves, while cholecalciferol (vitamin D3) improves calcium absorption from the gut. A key caution is to avoid taking more than the recommended amount, as excess calcium or vitamin D can cause high blood calcium and kidney-related problems.

• Prevention and treatment of calcium and vitamin D deficiency.
• Adjunctive treatment in osteoporosis or low bone mineral density when calcium and vitamin D supplementation is required.
• Supplementation in people with increased calcium and vitamin D needs, such as older adults, or during pregnancy and breastfeeding when recommended by a doctor.

The dose depends on the tablet strength, dietary intake, age, medical condition and blood calcium or vitamin D status. Adults are usually advised to take it with or after food to improve tolerance and absorption. Follow the dose and duration prescribed by the doctor, and do not exceed the recommended daily intake unless specifically instructed.

• Common side effects may include constipation, stomach discomfort, bloating, gas, nausea or vomiting.
• High intake may cause hypercalcemia, with symptoms such as unusual tiredness, excessive thirst, frequent urination, confusion, muscle weakness or loss of appetite.
• Kidney stones or worsening kidney problems may occur in susceptible people.
• Serious allergic reactions are rare but may include rash, swelling, dizziness or breathing difficulty and require urgent medical help.

Use caution in people with kidney disease, a history of kidney stones, high blood calcium, high urine calcium, hyperparathyroidism, sarcoidosis, prolonged immobilisation, heart disease, or those taking digoxin or diuretics. Avoid combining multiple calcium or vitamin D products unless advised. Use Calcium + Cholecalciferol (Vit. D3) under the guidance of a registered doctor or pharmacist, especially for long-term use or if you have other medical conditions.

• Calcium can reduce absorption of tetracycline and quinolone antibiotics; separate doses as advised by a healthcare professional.
• Calcium can reduce absorption of levothyroxine, bisphosphonates, iron, zinc and some other minerals or medicines; spacing doses is often needed.
• Thiazide diuretics may increase the risk of high blood calcium.
• Digoxin and other cardiac glycosides may have increased heart-related risks if calcium levels become high.
• Other vitamin D products or high-dose calcium supplements increase the risk of excessive calcium or vitamin D intake.
• Large amounts of high-oxalate or high-phytate foods may reduce calcium absorption if taken at the same time.

• Known hypersensitivity to calcium, cholecalciferol or any tablet ingredient.
• Hypercalcemia or significant hypercalciuria.
• Vitamin D toxicity.
• Severe kidney impairment or conditions causing abnormal calcium deposits, unless specifically managed by a specialist.
• Active kidney stones related to calcium, unless a doctor decides the benefit outweighs the risk.

Calcium and vitamin D are important during pregnancy and breastfeeding, but excessive intake can be harmful. Use during pregnancy or lactation should be based on dietary intake, supplement strength and the doctor’s recommendation, and high-dose vitamin D or calcium should not be taken without medical supervision.

Store in a cool, dry place away from direct sunlight and moisture. Keep the container tightly closed and out of the reach of children. Do not use after the expiry date printed on the pack.