Ostogen C

Ostogen C is indicated for the prevention and treatment of calcium deficiency and to support conditions of increased calcium demand. Indications, classified by strength of evidence, include:

• Established/standard uses: Prevention and treatment of dietary calcium deficiency; nutritional calcium supplementation.
• Guideline-supported uses: Adjunct to calcium and vitamin D therapy in the prevention of osteoporosis, particularly in postmenopausal women and older adults (used alongside, not as a replacement for, vitamin D and other osteoporosis-specific therapy).
• Increased physiological demand: Supplementation during pregnancy and lactation, during periods of rapid growth in children and adolescents, and in the elderly, when dietary calcium intake is insufficient.
• Adjunct therapy: As an adjunct in the management of conditions requiring calcium repletion (e.g., mild hypocalcemia), under medical supervision.

Ostogen C does not replace a balanced diet and, where relevant, vitamin D or other bone-specific therapy; use should be guided by a physician's assessment of individual calcium requirements.

Each unit of Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C typically contains a combination of two calcium salts — Calcium Lactate Gluconate and Calcium Carbonate — together providing elemental calcium, plus Vitamin-C (ascorbic acid), which supports calcium absorption and acts as an antioxidant. Exact strengths of elemental calcium and Vitamin-C per tablet/sachet vary by manufacturer and formulation; refer to the specific product label for the exact elemental calcium content.

Ostogen C is a combination mineral and vitamin supplement formulated to provide readily absorbable elemental calcium along with Vitamin-C. Combining two calcium salts (lactate gluconate and carbonate) allows a portion of the calcium to be absorbed even in relatively low-acid gastric conditions, while Vitamin-C is included to further support intestinal calcium absorption and provide antioxidant benefit. Ostogen C is commonly available as an effervescent tablet, chewable tablet, or similar oral dosage form intended for daily use in individuals with, or at risk of, calcium deficiency.

Calcium and Vitamin-C combination supplement (mineral and vitamin nutritional supplement); Ostogen C belongs to the class of calcium replacement/supplementation therapies.

Mechanism: Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C supplies elemental calcium from two complementary salts. Calcium Lactate Gluconate is highly water-soluble and can be absorbed with less dependence on gastric acidity, while Calcium Carbonate provides a concentrated source of elemental calcium that is best absorbed in an acidic gastric environment, typically with food. Calcium ions absorbed from Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C are essential for bone mineralization, neuromuscular transmission, blood coagulation, cardiac function, and enzyme activity.

Vitamin-C (ascorbic acid) in Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C enhances calcium bioavailability indirectly and acts as a co-factor in collagen synthesis (relevant to bone matrix formation) and as a water-soluble antioxidant.

Pharmacokinetics: Calcium absorption from Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C occurs mainly in the duodenum and proximal jejunum via active transport (vitamin D-dependent) and passive paracellular diffusion, and is influenced by dose, gastric acidity, and vitamin D status. Excess calcium is excreted renally and in feces.

Ostogen C effervescent tablets should be fully dissolved in a glass of water and consumed immediately after dissolving; chewable forms should be chewed thoroughly. It is generally recommended to take Ostogen C after meals to improve tolerability and absorption of the calcium carbonate component. If dosed more than once daily, doses should be spaced evenly through the day. Ostogen C should be separated by at least 2 hours from tetracycline or fluoroquinolone antibiotics, iron supplements, or thyroid hormone (levothyroxine) to avoid reduced absorption of either agent (see Interactions).

Ostogen C has clinically significant interactions with the following:

• Tetracycline and fluoroquinolone antibiotics: Calcium in Ostogen C chelates with these antibiotics, substantially reducing their absorption and efficacy; separate administration by at least 2-3 hours.
• Thiazide diuretics: Concurrent use with Ostogen C increases the risk of hypercalcemia due to reduced renal calcium excretion; monitor serum calcium.
• Digoxin (cardiac glycosides): Hypercalcemia resulting from excessive intake of Ostogen C can potentiate digoxin toxicity and increase the risk of cardiac arrhythmias; use cautiously with monitoring.
• Levothyroxine: Calcium in Ostogen C can reduce levothyroxine absorption; separate dosing by at least 4 hours.
• Bisphosphonates: Calcium in Ostogen C markedly reduces oral bisphosphonate absorption; administer bisphosphonates well before Ostogen C as per bisphosphonate labeling.
• Iron and zinc supplements: Ostogen C can reduce the absorption of concomitantly administered oral iron or zinc; separate dosing where possible.

Ostogen C is generally well tolerated at recommended doses. Reported side effects include:

• Common: Mild gastrointestinal disturbances such as constipation, bloating, flatulence, and abdominal discomfort, particularly with the calcium carbonate component.
• Less common: Nausea, dyspepsia.
• With excessive/prolonged use: Hypercalcemia and hypercalciuria (see Contraindications and Overdose Effects), which may present as fatigue, constipation, confusion, or renal stone formation.

Calcium supplementation with Ostogen C at recommended doses is generally considered appropriate during pregnancy and lactation, as calcium requirements increase during these periods; however, Ostogen C should be used only if clearly needed and as advised by a physician, who will individualize the dose based on dietary intake and total calcium requirement. Excessive supplementation with Ostogen C beyond recommended limits should be avoided during pregnancy and lactation, as it may increase the risk of hypercalcemia. Vitamin-C at supplemental doses is generally considered compatible with pregnancy and lactation. A physician or obstetric care provider should be consulted before use.

Ostogen C should be used with caution in the following situations:

• Renal impairment: Patients with renal insufficiency are at increased risk of hypercalcemia and should use Ostogen C only under medical supervision with periodic monitoring of serum calcium and renal function.
• History of renal calculi: Use Ostogen C cautiously, with adequate hydration, in patients with a history of calcium-containing kidney stones.
• Sarcoidosis or other granulomatous disease: These conditions increase sensitivity to calcium and vitamin D; avoid unsupervised use of Ostogen C (see Contraindications for hypercalcemia-associated conditions).
• Prolonged high-dose use: May lead to milk-alkali-like syndrome or hypercalcemia; do not exceed the recommended dose or duration without medical advice.
• Concomitant medications: Review timing with tetracyclines, fluoroquinolones, levothyroxine, and bisphosphonates before starting Ostogen C (see Interactions).

Overdose of Ostogen C can result in hypercalcemia, presenting with symptoms such as nausea, vomiting, constipation, abdominal pain, muscle weakness, confusion, excessive thirst, increased urination, and in severe cases, cardiac arrhythmias or renal impairment. Chronic excessive intake of Ostogen C may also cause hypercalciuria and nephrocalcinosis. In case of suspected overdose of Ostogen C, discontinue the product immediately and seek immediate medical attention or contact a poison control center; do not attempt specific home treatment. Management is supportive and may include hydration and medical monitoring of serum calcium under professional care.

Store at room temperature (below 30°C), away from light and moisture. Keep the container tightly closed, especially for effervescent formulations, to prevent moisture absorption. Keep out of reach of children.

Renal impairment: Use Ostogen C with caution and under medical supervision, as impaired renal clearance of calcium increases the risk of hypercalcemia (see Precautions and Warnings).

Hepatic impairment: No specific dose adjustment of Ostogen C is established for hepatic impairment; general precautions apply.

Elderly: Ostogen C is commonly used in the elderly for calcium supplementation and osteoporosis prevention; renal function should be considered.

Pediatric population: See Pediatric Uses.

Duration of treatment with Ostogen C depends on the indication: short-term supplementation may be sufficient to correct a mild dietary deficiency, while long-term daily use (months to years) is typical for ongoing prevention of calcium deficiency, during pregnancy/lactation, or as an adjunct in osteoporosis prevention. Duration should be determined by a physician based on periodic reassessment of dietary calcium intake and, where indicated, serum calcium levels.

Mineral supplement; Calcium supplement; Vitamin supplement (Vitamin-C/ascorbic acid combination)

Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C acts by directly supplying elemental calcium in two complementary chemical forms — calcium lactate gluconate (highly soluble, less dependent on gastric acid for dissolution) and calcium carbonate (a concentrated calcium source requiring gastric acid for optimal dissolution and absorption, typically taken with food). Absorbed calcium ions from Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C are utilized for bone and teeth mineralization, blood clotting, muscle contraction, nerve impulse transmission, and as a cofactor for various enzymatic reactions. Vitamin-C included in Calcium Lactate Gluconate + Calcium Carbonate + Vitamin-C supports collagen synthesis in bone matrix and may facilitate calcium absorption, in addition to its independent antioxidant role.

Ostogen C may be used in children and adolescents for calcium supplementation during periods of increased demand (growth, inadequate dietary intake), generally in age- or weight-adjusted doses under pediatric or physician guidance. Safety and efficacy of specific fixed-dose formulations of Ostogen C have not been formally established in very young children (e.g., under 2-3 years, depending on the formulation); such use should only occur under direct medical supervision. Ostogen C should not be used in children with hypercalcemia, hypercalciuria, or renal calculi (see Contraindications).