6.6.1.1 Calcium and vitamin D

Choice	Drug	Dosage
1st choice	Adcal-D3® Caplets 750mg/200IU	Dose: Two tablets to be taken twice a day
2nd choice	Calceos® 500mg/400IU chewable tablets	Dose: One tablet twice a day
Reserve (for patients who cannot swallow caplets or take chewable tablets)	Calfovit D3® 1200mg/800IU powder for oral suspension	Dose: 1 sachet per day (it is advised to take during the evening meal)

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. See National Osteoporosis Society website for information on calcium rich food and a calcium calculator.
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.
There is no convincing evidence associating calcium supplementation and cardiovascular disease. However, 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.