6.6.1. Calcium and vitamin D


Choice	Drug	Dosage
1st choice	Adcal-D3® Caplets (300mg calcium and 200IU vitamin D)	Dose: Two tablets to be taken twice a day
		or
		Accrete D3® tablets (600mg calcium and 400IU vitamin D)	Dose: One tablet twice a day
		or
		Accrete D3® One a Day (1000mg calcium and 880 IU viamin D) Chewable Tablets	Dose: One tablet daily
2nd Choice Reserve for swallowing difficulties	Adcal-D3® Dissolve effervescent tablets(1500mg calcium carbonate/ 400 IU vitamin D)	Dose: One tablet twice a day- dissolve in a glass of water (approx. 200ml) and drink immediately

Supplementation with calcium and vitamin D alone has been shown to reduce fracture rates in housebound elderly patients without previous fracture. Evidence in other patient groups is lacking.
Those with, or at risk of, osteoporosis should maintain adequate supply of calcium and vitamin D. If deficiency is suspected, this should be corrected by increasing dietary intake or taking supplements.
- Dietary sources of calcium are the preferred option, see Royal Osteoporosis Society website for information on calcium rich food and a calcium calculator.
- With the introduction of licensed vitamin D preparations, many clinicians are moving away from the use of combined calcium and vitamin D preparations in favour of single agent vitamin D preparations (in patients who are calcium replete).
For vitamin D guidance, see section 9.6.4 and for single agent calcium supplements, see section 9.5.1.1.