Accrete D3 One a Day 1000mg/880iu Chewable Tablets 30s

• Always take this medicine exactly as described in the leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
• The recommended dose is: Adults and elderly take 1 chewable tablet daily (corresponding to 1,000 mg of calcium and 880 IU (International Units) of vitamin D3).
• Pregnant women take only half a chewable tablet daily (corresponding to 500mg of calcium and 440 IU (International Units) of vitamin D3). The daily dose of half a tablet must not be exceeded.
• The chewable tablet has to be chewed before it is swallowed.
• You can take Accrete D3 One a Day Chewable Tablets at any time, with or without food.
• The tablet can be divided into equal doses.
• Accrete D3 One a Day Chewable Tablets should be taken as long-term treatment. Talk to your doctor how long you should take Accrete D3 One a Day Chewable Tablets

• Active Ingredients: 1,000 mg calcium (as calcium carbonate) and 22 micrograms cholecalciferol (vitamin D3 equivalent to 880 IU as concentrate powder form).
• Other Ingredients: Isomalt (E 953), xylitol, sorbitol (E 420), citric acid, anhydrous, sodium dihydrogen citrate, magnesium stearate, carmellose sodium, flavour orange “CPB” and flavour orange “CVT” (which both contain sorbitol (E 420)), aspartame (E 951), acesulfam potassium, sodium ascorbate, all-rac-alpha-tocopherol, modified (maize) starch, sucrose, triglycerides medium chain and silicon dioxide colloidal). Flavour orange “CPB” also contains benzyl alcohol as part of the natural/nature identical mandarine oil. 

• This medicine contains less than 1 mmol sodium (23 mg) per chewable tablet, that is to say essentially 'sodium-free'.
• This medicine contains 1.00 mg aspartame in each chewable tablet. Aspartame is a source of phenylalanine. It may be harmful if you have phenylketonuria (PKU), a rare genetic disorder in which phenylalanine builds up because the body cannot remove it properly.
• This medicine contains up to 152.89mg sorbitol (E420) in each chewable tablet. Sorbitol is a source of fructose. If your doctor has told you that you (or your child) have an intolerance to some sugars or if you have been diagnosed with hereditary fructose intolerance (HFI), a rare genetic disorder in which a person cannot break down fructose, talk to your doctor before you (or your child) take or receive this medicine.
• This medicine also contains isomalt (E953) and sucrose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. May be harmful to the teeth.
  This medicine contains 0.02mg benzyl alcohol in each chewable tablet. Benzyl alcohol may cause allergic reactions.

Do not take Accrete D3 One a Day 1000mg/880iu Chewable Tablets:

• If you are allergic to calcium, vitamin D3 or any of the other ingredients of this medicine.
• If you have high levels of calcium in your blood (hypercalcaemia).
• If you have high level of calcium in the urine (hypercalciuria).
• If you suffer from overactive parathyroid glands (hyperparathyroidism).
• If you suffer from bone marrow cancer (myeloma).
• If you suffer from cancer that has affected your bones (bone metastases).
• If you have a restraint of the limbs (prolonged immobilisation) accompanied with hypercalcaemia and/or hypercalciuria.
• If you have kidney stones (nephrolithiasis).
• If you have calcium deposits in your kidneys (nephrocalcinosis).
• If you suffer from an excessive supply of vitamin D (hypervitaminosis D).
• If you have severe kidney problems.
• If you are below 18 years of age.

Talk to your doctor or pharmacist before taking Accrete D3 One a Day Chewable Tablets if any of the following applies to you:

Long term treatment

• During long-term treatment the levels of calcium in your blood and urine and your kidney function have to be monitored regularly. This is especially important if you have a tendency to develop kidney stones. Depending on your blood levels your doctor might reduce the dose or discontinue the treatment.
  Simultaneous treatment with cardiac glycosides or thiazide diuretics (water tablets) for heart problems In such case the levels of calcium in your blood and urine and your kidney function have to be monitored regularly especially if you are elderly. Depending on your blood levels your doctor might reduce the dose or discontinue the treatment.
• Kidney problems
  • If you suffer from kidney problems you have to take Accrete D3 One a Day Chewable Tablets with special care, especially if you also receive aluminium-containing products as the citric acid in Accrete D3 One a Day Chewable Tablets might increase the uptake of aluminium. Your calcium levels of the blood and urine have to be checked. If you suffer from severe kidney problems, use other forms of vitamin D than cholecalciferol.
• Additional intake of calcium and vitamin D supplementation
  • Medical supervision is needed and your doctor will
    require frequent monitoring of the calcium levels in
    your blood and urine.
• Sarcoidosis (an immune system disorder which may affect your liver, lung, skin or lymph nodes)
  • Take special care when taking Accrete D3 One a Day Chewable Tablets if you suffer from sarcoidosis. There is a risk that the effect of this medicine gets too strong which can result in an overdose of calcium in the body. The levels of calcium in the blood and urine have to be monitored. In such case this medicine has to be used with special care, as the level of calcium in your blood might increase. Immobilised patients with osteoporosis.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

• In the case of simultaneous treatment with digitalis glycosides (cardiac glycosides derived from foxglove), cardiac arrhythmias can occur. Rigorous medical monitoring including an ECG and measurement of the blood calcium level is therefore necessary.
• In the case of simultaneous administration of diuretics of the thiazide medicine class (also called water tablets), the blood calcium level should be regularly monitored since thiazides decrease the excretion of calcium in the urine.
• The absorption and thus also the effectiveness of certain antibiotics (called tetracyclines) are decreased by the simultaneous administration of Accrete D3 One a Day Chewable Tablets. These medicines should be taken at least 2 hours before or 4-6 hours after Accrete D3 One a Day Chewable Tablets.
• Furthermore, other medicines such as sodium fluoride (used to strengthen the tooth enamel or to treat osteoporosis), quinolone antibiotics and bisphosphonate (used to treat osteoporosis) medicines are affected by interactions. These products should therefore be taken at least 3 hours before Accrete D3 One a Day Chewable Tablets.
• As long an interval as possible should be left between the administration of cholestyramine (a product to lower raised cholesterol levels), orlistat (a medicine used to treat obesity) or laxatives such as liquid paraffin and Accrete D3 One a Day Chewable Tablets since otherwise vitamin D is not absorbed properly.
• The simultaneous administration of Accrete D3 One a Day Chewable Tablets and rifampicin (an antibiotic), phenytoin (a product for the treatment of epilepsy) or barbiturates (hypnotics) can result in a reduction in the effect of vitamin D.
• The simultaneous administration of Accrete D3 One a Day Chewable Tablets and glucocorticoids (e. g. cortisone) can result in a reduction in the effect of vitamin D and to a decreased calcium level in the blood.
• The additional supplementation of calcium and vitamin D should be given only under medical supervision and will require frequent monitoring of the calcium levels in the blood and urine.
• Calcium may reduce the absorption of iron, zinc or strontium ranelate. Take these medicines at least two hours before or after Accrete D3 One a Day Chewable Tablets
• Calcium may reduce the absorption of the estramustin (a medicine used in chemotherapy) and thyroid hormones (used to treat thyroid deficiency). Take this medicine at least two hours after Accrete D3 One a Day Chewable Tablets.

Accrete D3 One a Day Chewable Tablets with food, drink and alcohol:

• Please note that oxalic acid (e.g. contained in spinach and rhubarb) and phytic acid (e.g. contained in wholegrain cereals) can reduce the amount of calcium you absorb in your bowel. In the 2 hours before or after eating food containing high amounts of oxalic or phytic acid you should not take medicines that contain calcium.

Pregnancy and breastfeeding:

• If you are pregnant you may use Accrete D3 One a Day Chewable Tablets in case of a calcium and vitamin D deficiency. The daily dose of half a tablet must not be exceeded. During pregnancy the total daily amount of calcium should not be higher than 1,500 mg and the total daily amount of vitamin D3 should not be higher than 600 IU (International Units). Long-term overdose of calcium and vitamin D during pregnancy must be avoided since this may lead to high levels of calcium in the blood and may have a negative effect on the unborn child. 
• Accrete D3 One a Day Chewable Tablets can be used during breast-feeding. As calcium and vitamin D pass into breast milk check with your doctor first if your child receives any other products containing vitamin D. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby ask your doctor or pharmacist for advice before taking this medicine.