Інструкція із застосування TONAKAL D3
Зміст інструкції
TONACAL D 600 mg + 400 U.I. chewable tablets
Calcium + cholecalciferol
Read this leaflet carefully before taking this medicinebecause it contains
important information for you.
- Keep this leaflet. You may need to read it again. If you have any questions, ask your doctor, pharmacist or nurse.
- This medicine is only to be used in adult patients. This medicine has been prescribed only for you. Do not give it to other people, even if their symptoms are the same as yours, because it could be dangerous. If any undesirable effect occurs, including any not listed in this leaflet, consult your doctor, pharmacist or nurse. See section 4.
Contents of this leaflet:
- 1. What Tonacal D is and what it is used for
- 2. What you need to know before you take Tonacal D
- 3. How to take Tonacal D
- 4. Possible side effects
- 5. How to store Tonacal D
- 6. Contents of the pack and other information
1. WHAT IS TONACAL D AND WHAT IS IT FOR
Tonacal D chewable tablets contains two active ingredients, calcium carbonate and cholecalciferol (vitamin
D) which are normally taken with the diet; furthermore, vitamin D is produced in the skin after
sun exposure.
Tonacal D chewable tablets may be prescribed by your doctor for the treatment and prevention of
vitamin D and calcium deficiencies.
Tonacal D is used:
- for the correction of calcium and vitamin D deficiency in the elderly;
- in association with the treatment of osteoporosis when calcium and vitamin D levels are too low or in the presence of a high risk of becoming too low.
2. BEFORE TAKING TONACAL D
Do not take Tonacal D
- if you are allergic to calcium, vitamin D or any of the excipients of Tonacal D (in particular to soybean oil);
- if you have high levels of calcium in the blood (hypercalcemia) or in the urine (hypercalciuria);
- if you have severe kidney problems;
- if you have kidney stones;
- if you have high levels of vitamin D in the blood (hypervitaminosis D).
Warnings and precautions
- if you have had kidney stones or other kidney problems (your doctor will carefully monitor treatment with Tonacal D if your kidneys do not function properly, to prevent the calcium in the blood from reaching too high levels);
- if you are bedridden for a long period (months) and suffer from osteoporosis (brittle bones) as you may have high levels of calcium in the blood;
- if you are taking other medicines containing calcium or vitamin D, your doctor or pharmacist will tell you what to do;
- if you have sarcoidosis, your doctor will tell you what to do.
Other medicines and Tonacal D
Do not take Tonacal D without informing your doctor or pharmacist if you are taking:
- any other medicine containing Vitamin D;
- the following medicines for the heart: digoxin or other cardiac glycosides;
- tetracycline and fluoroquinolone antibiotics; it is recommended to allow at least 3 hours to pass after taking them before taking Tonacal D chewable tablets;
- thiazide diuretics;
- if you are using other medicines for the treatment of bone diseases, such as bisphosphonates or sodium fluoride, it is recommended to allow at least 3 hours to pass after taking them before taking Tonacal D chewable tablets.
- Phenytoin (medicine for epilepsy) and barbiturates (medicines used for epilepsy or to promote sleep), as they decrease the action of vitamin D.
- Rifampicin, as it makes vitamin D3 less effective Orlistat (medicine for the treatment of obesity), colestyramine, laxatives such as paraffin oil, as they can reduce the absorption of vitamin D.
- Estramustine (medicine used in chemotherapy), thyroid hormones or medicines based on iron, zinc or strontium ranelate, as the amount absorbed may be reduced. These medicines must be taken at least 2 hours before or after taking Tonacal D3.
Tonacal Dwith food and drink
This medicine can interact with certain foods, for example those containing oxalic acid
(such as spinach, rhubarb, sorrel, cocoa, tea, etc.), phosphate (such as ham, sauces, processed cheese, etc.) or
phytic acid (such as legumes, whole grains, chocolate, etc.). Therefore, it is recommended to take Tonacal D
two hours before or after a meal based on these foods.
Pregnancy and breastfeeding
Tonacal D chewable tablets should be used during pregnancy and breastfeeding only if
recommended by your doctor.
Important information about some excipients of Tonacal D
The product contains: sorbitol (E 420), aspartame (E 951), lactose, hydrogenated soybean oil, sucrose.
The product contains aspartame which is a source of phenylalanine. Phenylalanine may be dangerous for patients
with phenylketonuria.
The product contains lactose, sucrose and sorbitol, therefore if your doctor has informed you that you have an
intolerance to certain sugars, contact your doctor before taking Tonacal D.
The product contains soybean oil, therefore if you are allergic to peanuts or soy, do not take this
medicine.
3. HOW TO TAKE TONACAL D
Always take Tonacal D exactly as your doctor has instructed. If you have any doubts, consult your
doctor.
The usual dose for adults and elderly patients is one chewable tablet twice a day (e.g.
one in the morning and one in the evening), preferably taken after meals.
The tablets must be chewed or allowed to dissolve in the mouth; they must not be swallowed whole.
If you take more Tonacal D than you should
Contact your doctor. If you cannot do so, go to the nearest emergency room, bringing with you
any remaining tablets and the packaging.
If you forget to take Tonacal D
Take the tablet as soon as possible. Afterwards, take your next dose at the usual time. However,
if it is almost time for your next dose, do not take the forgotten dose and continue as usual. Never take
a double dose to make up for a missed dose.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Tonacal D can cause side effects, although not everybody gets them.
The following side effects are uncommon (present in 1–10 patients per 1,000):
- hypercalcemia (too much calcium in the blood) - symptoms are nausea, vomiting, loss of appetite, constipation, stomach pain, bone pain, excessive thirst, a need to urinate more than usual, muscle weakness, drowsiness and confusion;
- hypercalciuria (too much calcium in the urine); The following side effects are rare (present in 1-10 patients per 10,000):
- nausea;
- stomach pain;
- constipation;
- diarrhea;
- flatulence;
- itching;
- skin rash;
- urticaria.
The frequency of the following side effects is not known (the frequency cannot be estimated from the available
data):
- Serious allergic reactions (hypersensitivity) such as e.g. swelling of the face, lips or tongue.
Special populations
Patients with kidney impairment: there is a potential risk of hyperphosphataemia, nephrolithiasis and nephrocalcinosis.
Reporting of side effects
If you get any side effects, even those not listed in this leaflet, tell your
doctor or pharmacist.
You can also report side effects directly through the national reporting system
at www.agenziafarmaco.gov.it/content/come-segnalare-una-sospetta-reazione-avversa
By reporting side effects you can help provide more information on the safety of
this medicine.
5. HOW TO STORE TONACAL D
Do not store at a temperature above 30°C.
Store in the original container to protect the medicine from moisture.
Keep this medicine out of the sight and reach of children.
Do not take Tonacal D after the expiry date which is stated on the pack after the abbreviation “Exp.”.
The expiry date refers to the last day of the month.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how
to dispose of medicines you no longer use. This will help protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What Tonacal D contains
- Each tablet contains the active ingredients calcium carbonate (1500 mg equivalent to 600 mg of Calcium) and cholecalciferol (Vitamin D) (400 I.U. equivalent to 0.01 mg).
- The excipients are: sorbitol (E 420), maltodextrins, sodium croscarmellose (E 468), aspartame (E 951), sodium saccharin (E 954), lactose monohydrate, anise aroma, mint aroma, molasses aroma, magnesium stearate, DL-α-tocopherol (E 307), hydrogenated soybean oil, gelatin, sucrose, corn starch.
Description of the appearance of Tonacal D and contents of the pack
The tablets have a circular shape with beveled edges, are white or almost white in color with
the inscription “D” on one side.
Bottle containing 60 chewable tablets.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
S.F. Group Srl – via Tiburtina, 1143 – 00156 Roma
Manufacturer responsible for batch release:
Italfarmaco S.p.A. - Viale Fulvio Testi, 330 – 20126 Milano
This leaflet was last approved on
- Країна реєстрації
- Лікарська формаChewable tablet, 600 MG/400 U.I.
- Потрібен рецептТак
- Виробник
- Ця інформація надана лише для ознайомлення і не є медичною порадою. Рішення щодо лікування завжди приймає лікар.
- Альтернативи до TONAKAL D3Лікарська форма: Coated tablet, 1000 MGДіюча речовина: Карбонат кальцияВиробник: THERAMEX IRELAND LIMITEDПотрібен рецептЛікарська форма: Injectable solution, 10 %Діюча речовина: глюконат кальцияВиробник: B. BRAUN MELSUNGEN AGПотрібен рецептЛікарська форма: Injectable solution, 500 MG/5 MLДіюча речовина: глюконат кальцияПотрібен рецепт
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Лікарі онлайн щодо TONAKAL D3
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Заповніть форму за 2 хвилини
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Часті запитання
TONAKAL D3 потребує рецепта в Італія. Ви можете обговорити з лікарем онлайн, чи підходить цей лікарський засіб для вашої ситуації.
TONAKAL D3 виробляється компанією S.F. GROUP S.R.L.. Назва бренду та упаковка можуть відрізнятися залежно від дистрибʼютора.
Лікарі, зокрема Сімейні лікарі, Психіатри, Дерматологи, Кардіологи, Ендокринологи, Гастроентерологи, Пульмонологи, Нефрологи, Ревматологи, Гематологи, Інфекціоністи, Алергологи, Геріатри, Педіатри, Онкологи, можуть оцінити доцільність застосування TONAKAL D3 з урахуванням вашого стану та місцевих правил. Ви можете записатися на онлайн-консультацію, щоб обговорити симптоми та можливі подальші кроки.
Польща має добре розвинену систему охорони здоров'я у великих містах, таких як Варшава, Краків, Вроцлав і Гданськ. Аптеки широко доступні та працюють відповідно до чинного законодавства, забезпечуючи доступ до рецептурних препаратів.
Ви можете придбати TONAKAL D3 у Варшаві, Кракові, Вроцлаві або Гданську в будь-якій аптеці за наявності дійсного рецепта.
Щоб отримати рецепт, ви можете скористатися Oladoctor:
Інші препарати з тією самою діючою речовиною () включають KAKIT, KALKIO LUKONATO B. BRAUN, KALKIO LUKONATO BIOINDUSTRIA L.I.M.. Вони можуть відрізнятися торговою назвою або формою випуску, але містять той самий терапевтичний компонент. Перед зміною або початком прийому нового препарату варто проконсультуватися з лікарем.
















