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Calcium + Cholecalciferol

Fixed-dose combination: calcium salt (carbonate) plus vitamin D3

ATC code: A12AX(Calcium, combinations with other drugs)

Updated · Methodology

Indications

A

Osteoporosis

First line

Prevention and treatment of osteoporosis combined with disease-modifying therapy (bisphosphonates, denosumab, romosozumab). Per NOF 2022 and SEIOMM 2022, without adequate calcium and vitamin D any osteoporosis therapy loses efficacy. Dose: 1000–1500 mg elemental calcium + 800–1000 IU vitamin D3 per day, in two divided doses with meals. Do not co-administer calcium with bisphosphonates – separate by at least 2 hours. Baseline 25(OH)D – correct deficiency with cholecalciferol monotherapy first.

Sources

  1. AEMPS: Ficha técnica de Calcio + Colecalciferol (2024)
  2. Cochrane Database Syst Rev: Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. (2014)
  3. Osteoporos Int: Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. (2016)
  4. JAMA: Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis. (2017)

ICD-10: M81 · ICD-11: FB83.1

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

D

Anti-aging and longevity

Not recommended

Calcium + vitamin D is often marketed to all adults for strong bones, immunity, and longevity. Per NOF 2022, 2018, and SEIOMM 2022, in healthy adults without osteoporosis, prior low-energy fractures, or confirmed vitamin D deficiency, daily supplementation does not reduce fracture risk or improve survival. High calcium intake (>1500 mg/day from diet plus supplements) increases kidney-stone risk and, by some meta-analyses, cardiovascular events. If prescribed for prevention without osteoporosis or vitamin D deficiency, consider getting a second opinion and a DXA scan.

Sources

  1. AEMPS: Ficha técnica de Calcio + Colecalciferol (2024)
  2. Cochrane: Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases (2012)
How to read tiers A–F
  • AStrong evidence – first or second line in international guidelines
  • BRecommended in selected cases
  • CStudy data contradict each other
  • DBenefit not proven, no documented harm
  • FDocumented harm, or risk without benefit

Mechanism of action

Calcium carbonate provides elemental calcium (40% by weight) for bone mineralization. Cholecalciferol (vitamin D3) is converted in the liver to 25(OH)D and in the kidney to active 1,25(OH)2D. The active metabolite enhances intestinal calcium absorption and renal reabsorption, supporting osteoid mineralization. The combination corrects deficiency of both substrates without which osteoporosis therapy fails.

Safety

Contraindications

  • Hypercalcemia, hypercalciuria
  • Severe renal impairment
  • Vitamin D toxicity
  • Nephrocalcinosis, calcium-stone disease
  • Sarcoidosis and other granulomatous diseases (hypercalcemia risk)

Serious adverse effects

  • Hypercalcemia (long-term high-dose)
  • Kidney stones
  • Milk-alkali syndrome with antacid co-use

Common adverse effects

  • Constipation
  • Bloating
  • Nausea
  • Dry mouth

Pregnancy: can you take Calcium + Cholecalciferol?

Compatible. Used to meet physiological requirements in pregnancy (per ACOG 2018, 1000–1300 mg calcium and 600 IU vitamin D daily). Do not exceed the dose.

Breastfeeding: can you take Calcium + Cholecalciferol?

Fully compatible. Hale L1. Covers nursing mother's physiological needs (1300 mg calcium, 600 IU vitamin D).

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Practical notes

Timing and administration

Take with meals (calcium carbonate absorbs best in acidic gastric environment). Do not co-administer with iron, levothyroxine, or bisphosphonates – separate by at least 2 hours.

Monitoring

Serum calcium and 25(OH)D every 6–12 months. If calcium >10.5 mg/dL, reassess the dose. Use with caution in chronic kidney disease.

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Frequently asked

What is Calcium + Cholecalciferol used for?

Calcium + Cholecalciferol is evaluated for the following indications with varying evidence strength: Osteoporosis (evidence tier A), Anti-aging and longevity (evidence tier D). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Calcium + Cholecalciferol?

Common side effects of Calcium + Cholecalciferol (≥ 1 in 100): Constipation, Bloating, Nausea, Dry mouth. See the Safety section for uncommon and serious reactions.

Is Calcium + Cholecalciferol safe during pregnancy?

Compatible. Used to meet physiological requirements in pregnancy (per ACOG 2018, 1000–1300 mg calcium and 600 IU vitamin D daily). Do not exceed the dose.

Is Calcium + Cholecalciferol compatible with breastfeeding?

Fully compatible. Hale L1. Covers nursing mother's physiological needs (1300 mg calcium, 600 IU vitamin D).

Who should not take Calcium + Cholecalciferol?

Calcium + Cholecalciferol is contraindicated in: Hypercalcemia, hypercalciuria; Severe renal impairment; Vitamin D toxicity; Nephrocalcinosis, calcium-stone disease; Sarcoidosis and other granulomatous diseases (hypercalcemia risk). Full list in the Safety section.

Other drugs in this group

Calcium D-glucarate, Chromium picolinate, Copper, Magnesium (oral salts: citrate, glycinate, oxide, sulfate), Magnesium sulfate, Phosphorus, Zinc (oral salts: picolinate, citrate, gluconate, oxide, acetate), Magnesium L-threonate (Magtein)