Calchew D3 Dosage According to BNFC
According to the British National Formulary for Children (BNFC), Calcichew D3 Forte is recommended at a dose of two tablets daily, which provides 800 IU of vitamin D3 (cholecalciferol) and 1000 mg of calcium. 1
Composition and Formulation
- Each Calcichew D3 Forte tablet contains:
- 400 IU of vitamin D3 (cholecalciferol)
- 500 mg of calcium
Dosing Recommendations
Standard Dosing
- Children: Two tablets daily (providing 800 IU vitamin D3 and 1000 mg calcium)
- Adults: Two tablets daily (providing 800 IU vitamin D3 and 1000 mg calcium)
Administration Guidance
- Tablets should be chewed or crushed before swallowing
- Can be used as an alternative to "calcium and ergocalciferol" when the latter is not well tolerated 1
- Should not be taken simultaneously with other calcium supplements or foods with high calcium content (like milk) as this may reduce absorption
Clinical Considerations
Indications for Use
- Prevention of vitamin D and calcium deficiency
- Supplementation during steroid therapy 1
- Management of conditions requiring calcium and vitamin D supplementation
- Bone health maintenance in conditions like inflammatory bowel disease
Monitoring
- No routine monitoring is required when using standard doses 1
- For patients on long-term therapy, consider periodic assessment of serum calcium levels
- Target serum 25(OH)D levels should be maintained above 30 ng/mL (75 nmol/L) for optimal bone health 2
Special Populations
- Patients with renal impairment: Dose may need adjustment based on severity of impairment
- Pregnant women: Assessment of vitamin D status before conception or early in pregnancy is recommended 1
- Patients with inflammatory bowel disease: May benefit particularly from this supplementation during steroid therapy 1
Potential Side Effects
- Gastrointestinal symptoms (more common with calcium carbonate formulations)
- Hypercalcemia (rare at recommended doses)
- Hypercalciuria (may contribute to nephrocalcinosis in susceptible individuals)
Alternative Formulations
If Calcichew D3 is not tolerated, consider:
- Separate administration of calcium and vitamin D supplements
- Calcium citrate formulations (may be better absorbed and cause fewer GI side effects) 3
Remember that calcium and vitamin D supplementation forms the basis of preventive and therapeutic regimens for bone health, and adequate supplementation is essential, particularly in patients receiving medications that may affect bone metabolism.