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  Each tablet of Trical HD contains:
  1250 mg Calcium Carbonate from an organic source (Oyster shell) equivalent to
Elemental Calcium ......................500mg
Vitamin D3 coated equivalent
to Vitamin D3...........................500IU
  Therapeutic Indications & Usage
  Oral Supplementation of calcium and vitamin D3
  Patients with hypercalcaemia and/or hypercalciuria. Nephrolithiasis, hypervitaminosis D, hypophosphataemia.
  Overdosage Overdose can lead to hypercalcaemia. Symptoms: Anorexia, thirst, nausea, vomiting, constipation, abdominal pain, muscle weakness, fatigue, bone pain, nephrocalcinosis, nephrolithiasis, mental disturbances, polydipsia, polyuria and cardiac arrhythmias (severe cases). Extreme hypercalcaemia may lead to coma and death. Irreversible renal damage and soft tissue calcification may occur as a result of prolonged hypercalcaemia. Treatment of hypercalcaemia: Rehydrate and discontinue calcium supplement and any treatment with thiazide diuretics, lithium, vitamin A or D and cardiac glycosides. Monitor serum electrolytes, renal function and diuresis.
  Special Precautions
  Impaired calcium absorption in achlorhydria which is common in elderly. Increased risk of hypercalcaemia and hypercalciuria in hypoparathyroid patients receiving high doses of vitamin D. Caution when using in patients with history of kidney stones. Renal impairment; frequent monitoring of serum calcium and phosphorus is recommended.
  Adverse Drug Reactions
  Constipation, flatulence, nausea, abdominal pain and diarrhoea. Pruritus, rash and urticaria.
  Drug Interactions
  May affect the absorption of tetracycline when used together. Concurrent use with systemic corticosteroids may reduce calcium absorption. Thiazide diuretics may decrease urinary excretion of calcium. Concurrent use with ion-exchange resins may reduce GI absorption of vitamin D. Hypercalcaemia may increase the toxicity of cardiac glycosides during treatment with calcium and vitamin D, monitor ECG and serum calcium levels. Bisphosphonate or sodium fluoride should be given at least 3 hr before calcium-containing preparations.
  Recommended Dosage & Administration
  One tablet twice daily

A Blister strip of 15 Tablets
Pack shot of Trical HD

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