Bone Health Care Products online in Pakistan - GlossMeUp https://glossmeup.com/product-category/bone-health/ Multi-Vitamins and supplements Wed, 22 Apr 2026 05:01:14 +0000 en-US hourly 1 https://wordpress.org/?v=7.0 https://glossmeup.com/wp-content/uploads/2025/01/gmu-icon-32x32.webp Bone Health Care Products online in Pakistan - GlossMeUp https://glossmeup.com/product-category/bone-health/ 32 32 Gumi Plus Grow & Excel Kids Gummies https://glossmeup.com/product/gumi-plus-grow-excel-kids-gummies/ https://glossmeup.com/product/gumi-plus-grow-excel-kids-gummies/#respond Tue, 11 Jan 2022 11:34:10 +0000 https://glossmeup.com/?post_type=product&p=4572
  • Gummies make it easy; delicious; and fun with important vitamins for kids in great-tasting strawberry flavors
  • Omega 3 with vitamins A, C, D, E, and B contributes to brain development
  • A multivitamin for kids specially crafted to support healthy growth and development
  • Helps to support their immune system with antioxidants
  • Vitamin D aids better calcium absorption
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    What it is.
    Grow & Excel is our kids Multivitamin with Omega-3 packed in a yummy tasty gummy for your child to get an essential dose of vitamins and minerals they need every day for healthy development.

    Benefits

    • Gummies make it easy; delicious; and fun with important vitamins for kids in great-tasting strawberry flavors
    • Omega 3 with vitamins A, C, D, E, and B contributes to brain development
    • A multivitamin for kids specially crafted to support healthy growth and development
    • Helps to support their immune system with antioxidants
    • Vitamin D aids better calcium absorption

    Dosage

    Have two gummies per day

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    Gumi Plus Immunity & Sunshine Gummies https://glossmeup.com/product/gumi-plus-immunity-sunshine-gummies/ https://glossmeup.com/product/gumi-plus-immunity-sunshine-gummies/#respond Tue, 11 Jan 2022 11:15:29 +0000 https://glossmeup.com/?post_type=product&p=4564
  • Essential Nutrient to support bones and teeth
  • Supports immune health
  • Increases absorption of calcium which is crucial for bone health
  • High potency Vitamin D
  • Delicious flavored Halal Gummies
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    What it is.
    With Gumi Plus Immunity & Sunshine get your daily dose of the sunshine vitamin, no matter what the weather is outside.  Vitamin D3 Gummies are a fun way to support your immune system while providing support for strong teeth and bones.

    Benefits

    • Essential Nutrient to support bones and teeth
    • Supports immune health
    • Increases absorption of calcium which is crucial for bone health
    • High potency Vitamin D
    • Delicious flavored Halal Gummies

    Dosage

    Have two gummies per day regularly

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    TURMERIC & BLACK PEPPER https://glossmeup.com/product/turmeric-black-pepper/ https://glossmeup.com/product/turmeric-black-pepper/#respond Wed, 03 Nov 2021 11:43:30 +0000 https://glossmeup.com/?post_type=product&p=3868 Combining two ingredients that help you experience wellness in your everyday life

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    Overview

    Say goodbye to years old aches and pains.

    Turmeric is an herbal component with a long history of use in India. The active ingredients in Turmeric include beneficial flavonoids called Curcuminoids, which are plant-based antioxidants.

    The piperine present in Black Pepper enhances Turmeric and Boswellia absorption in your body so that you can say ‘yes to the new adventures waiting ahead.

     

    Reasons to Love

    Anti-Inflammatory

    Curcumin in turmeric has natural anti-inflammatory and antioxidant properties which help stimulate your body’s enzymes.

    Supports Healthy Bones & Joints

    Curcumin present in turmeric proves to be an active joint support system resulting in stronger bones and prevention of stiffness in joints.

     

    Healing Attributes

     

    The pain relief and healing attributes of this unique combination are worthwhile. For any unhealed wounds, Turmeric and Boswellia prove to be a substantial damage repair and may also help you recover from joint pain naturally.

     

    Promotes Youthful Skin 

    Curcumin, a major component of turmeric, has strong antioxidant properties and controls aging by protecting cells from damage, making it a natural anti-aging solution.

    High Bioavailability

    The combination of turmeric with black pepper, with the help of piperine, helps your body absorb more curcumin which makes these ingredients perform at the optimum level.

    Supports Healthy Immune System

    Adding Turmeric & Black Pepper to your diet will naturally help bolster the immune system by increasing the immunomodulating capacity of the body.

    Reduces Arthritis Symptoms

    turmeric and its major compounds, such as curcumin, may help alleviate or prevent symptoms of arthritis.

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    Vilgo-D Plus https://glossmeup.com/product/vilgo-d-plus/ https://glossmeup.com/product/vilgo-d-plus/#comments Tue, 26 Oct 2021 11:18:53 +0000 https://glossmeup.com/?post_type=product&p=3741 Stronger Bones, Stronger You

    Replenishes vitamin D stores.
    Strengthen Bones.
    Helps in regulating heart health.
    Boosts Immunity.

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    Bonaid D https://glossmeup.com/product/bonaid-d/ https://glossmeup.com/product/bonaid-d/#respond Wed, 13 Oct 2021 17:57:13 +0000 https://glossmeup.com/?post_type=product&p=3631 1.  Supports bone health and density
    2.  Improves immunity
    3.  Improves mood and sleep quality
    4.  Helps regulate blood sugar levels.
    5. Improves metabolism and fastens the healing of wounds.

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    1.  Supports bone health and density
    2.  Improves immunity
    3.  Improves mood and sleep quality
    4.  Helps regulate blood sugar levels.
    5. Improves metabolism and fastens the healing of wounds.

    Each Tablet contains:

    Calcium 1200mg
    Magnesium 30mg
    Vitamin D3 800IU
    Zinc 10mg

    Dosage:
    Take 1 Tablet daily with water preferably after a meal.

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    D-One Tablets https://glossmeup.com/product/d-one-tablets/ https://glossmeup.com/product/d-one-tablets/#respond Wed, 13 Oct 2021 17:41:21 +0000 https://glossmeup.com/?post_type=product&p=3623 Vitamin D is required for the regulation of the amounts of phosphate and calcium in our bodies. It plays a vital role in ensuring that our muscles, teeth and bones remain healthy at all times and also maintains the immune system.

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    Vitamin D is required for the regulation of the amounts of phosphate and calcium in our bodies. It plays a vital role in ensuring that our muscles, teeth and bones remain healthy at all times and also maintains the immune system.

    D-One tablets are the perfect pick for those who are suffering from a lack of Vitamin D, or those who wish to ensure that their bodies receive the right amounts of this important nutrient. The tablets assist in calcium absorption, reduce the risk of rickets and osteoporosis and even promote good health.

    Each tablet contains:
    Vitamin D3 ——— 5000IU

    Directions:
    Take 1 Tablet daily with water preferably after the meal.

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    GC Plus https://glossmeup.com/product/gc-plus/ https://glossmeup.com/product/gc-plus/#respond Thu, 02 Sep 2021 16:30:39 +0000 https://glossmeup.com/?post_type=product&p=2448 A top-Notch solution for painful joints.
    • Helps to treat all forms of Osteoarthritis.
    • Helps to maintain healthy joints and connective tissues.
    • Promotes joint comfort & mobility.
    • Helps to rebuild cartilage.

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    Exen-D Plus Sachet https://glossmeup.com/product/exen-d-plus-sachet/ https://glossmeup.com/product/exen-d-plus-sachet/#respond Thu, 02 Sep 2021 16:29:04 +0000 https://glossmeup.com/?post_type=product&p=2446

    Exen D is combination product of Calcium (Calcium from Natural Origin) & Vitamin D (Cholecalciferol from Natural Origin). This combination medication is used to prevent or treat low blood Calcium levels in people who do not get enough Calcium from their diets.

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    Exen D Plus https://glossmeup.com/product/exen-d-plus/ https://glossmeup.com/product/exen-d-plus/#respond Thu, 02 Sep 2021 16:27:30 +0000 https://glossmeup.com/?post_type=product&p=2444

    Calcium in the bones, where it belongs

    • Ensures Bones Health
    • Effective calcium Absorption
    • Good for Heart & Kidneys
    • Recommended for All Ages
    • Reduces Hypertension & diminishes symptoms of PMS

    More Detail About Exen D Plus

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    COMPOSITION:

    Each tablet of Exen D Plus contains:
    Calcium (Calcium from Natural Origin) …………………….500mg
    Vitamin D (Cholecalciferol from Natural Origin) ……….2000 IU

    DESCRIPTION:

    Exen D is combination product of Calcium (Calcium from Natural Origin) & Vitamin D (Cholecalciferol from Natural Origin). This combination medication is used to prevent or treat low blood Calcium levels in people who do not get enough Calcium from their diets. It may be used to treat conditions caused by low Calcium levels such as bone loss (Osteoporosis), weak bones (Osteomalacia/Rickets), decreased activity of the parathyroid gland (Hypoparathyroidism) and a certain muscle disease (Latent tetany). It may also be used in certain patients to make sure they are getting enough Calcium (e.g. women who are pregnant, nursing or postmenopausal, people taking certain medications such as Phenytoin, Phenobarbital or Prednisone). Calcium plays a vital role and is necessary for normal functioning of nerves, cells, muscles and bones. If there lack calcium in the blood, then the body consumes calcium from the bones, leading to weaker bones. Vitamin D helps body to absorb Calcium and Phosphorus, extremely essential for building and keeping strong bones.

    Exen D Plus is a special bone-building formula. It combines Vitamin K2-7, Calcium and Vitamin D all at clinically researched doses in one formulation. Just two tablets or one sachet a day of Exen D Plus is an effective way to protect against Osteoporosis and build stronger bones for the future.

    CLINICAL PHARMACOLOGY:

    Pharmacodynamics:

    Cholecalciferol (Vitamin D) is a Steroid hormone that has long been known for its important role in regulating body levels of Calcium and Phosphorus, in mineralization of bone and for the assimilation of Vitamin A. The clinical manifestations of Vitamin D deficiency are Rickets, which is seen in children and results in bone deformities including bowed long bones. Deficiency in adults leads to the disease called Osteomalacia. Both Rickets and Osteomalacia reflect impaired mineralization of newly synthesized bone matrix and usually result from a combination of inadequate exposure to sunlight and decreased dietary intake of Vitamin D. Common causes of Vitamin D deficiency include genetic defects in the Vitamin D receptor, severe liver or kidney disease and insufficient exposure to sunlight. Vitamin D plays an important role in maintaining Calcium balance and in the regulation of Parathyroid hormone (PTH). It promotes renal reabsorption of Calcium, increases intestinal absorption of Calcium and Phosphorus and increases Calcium and Phosphorus mobilization from bone to plasma.

    Calcium carbonate acts by directly increasing Calcium stores within the body. Calcium (Caz‘) plays a vital role in the physiology and biochemistry of organisms and the cell. It plays an important role in signal transduction pathways, where it acts as a second messenger in neurotransmitter release from neurons, contraction of all muscle cell types and fertilization. Many enzymes require Calcium ions as a cofactor, those of the blood clotting cascade being notable examples. Extracellular Calcium is also important for maintaining the potential difference across excitable cell membranes, as well as proper bone formation.

    Pharmacology:

    Vitamin D is produced in the skin by photochemical conversion of 7-dehydrocholesterol to pre-vitamin D by ultraviolet light. This is followed by non-enzymatic isomerization to Vitamin D. In the absence of adequate sunlight exposure, Vitamin D is an essential dietary nutrient. Vitamin D in skin is converted to 25—hydroxyvitamin D in the liver. Conversion to the active Calcium—mobilizing hormone 1,25— dihydroxyvitamin D (Calcitriol) in the kidney is stimulated by both Parathyroid hormone and Hypophosphatemia. The principal action of 1,25-dihydroxyvitamin D is to increase intestinal absorption of both Calcium and Phosphate as well as regulate serum Calcium, renal Calcium and Phosphate excretion, boneformation and bone resorption.

    Vitamin D is required for normal bone formation. Vitamin D insufficiency develops when both sunlight exposure and dietary intake are inadequate. Insufficiency is associated with negative Calcium balance, increased Parathyroid hormone levels, bone loss and increased risk of skeletal fracture. In severe cases, deficiency results in more severe hyperparathyroidism, hypophosphatemia, proximal muscle weakness, bone pain and osteomalacia. The first step involved in the activation of Vitamin D is a 25-hydroxylation which is catalysed by the 25-hydroxylase in the liver and then by other enzymes. The mitochondrial sterol 27-hydroxylase catalyses the first reaction in the oxidation of the side chain of sterol intermediates. The active form of Vitamin D (Calcitriol) binds to intracellular receptors that then function as transcription factors to modulate gene expression. Like the receptors for other steroid hormones and thyroid hormones, the Vitamin D receptor has hormone-binding and DNA-binding domains. The Vitamin D receptorforms a complex with another intracellular receptor, the retinoid-X receptor, and that heterodimer is what binds to DNA. In most case studieds, the effect is to activate transcription, but situations are also known in which Vitamin D suppresses transcription.

    Calcitriol increases the serum Calcium concentrations by:

    Increasing GI absorption of Phosphorus and Calcium, increasing osteoclastic resorption and increasing distal renal tubular reabsorption of Calcium. Calcitriol appears to promote intestinal absorption of Calcium through binding to the Vitamin D receptor in the mucosal cytoplasm ofthe intestine. Subsequently, Calcium is absorbed through formation of a Calcium-binding protein. Calcium exist in bones in the form of hydroxyapatite. Hydroxyapatite comprises of approximately 40% of the weight of the bone. Exen D/Exen D Plus has been found to reduce colonic mucosal proliferation Calcium ions may precipitate bile acids and fatty acids that can stimulate the proliferation of colon cells. Exen D/Exen D Plus has been found to have the modest effect on the reduction of systolic blood pressure in those with hypertension. Diastolic pressure does not appear to be affected by Calcium. More than 500 human proteins are known to bind or transport Calcium. The skeleton acts as a major mineral storage site for the element and releases Ca” ions into the bloodstream under controlled conditions. Circulating Calcium is either in the free, ionized form or bound to blood proteins such as serum Albumin. Parathyroid hormone (secreted from the parathyroid gland) regulates the resorption of Ca” from bone. Calcitonin stimulates incorporation of Calcium in bone, although this process is largely independent of calcitonin. Although Calcium flow to and from the bone is neutral, about 5 mmol is turned over a day. Bone serves as an important storage point for Calcium, as it contains 99% of the total body Calcium. Low Calcium intake may also be a risk factor in the development of Osteoporosis.The currently recommended Calcium intake is 1,500 milligrams per day for women not taking Estrogen and 800 milligrams per day for women on Estrogen. There is close to 300 milligrams of Calcium in one cup of fluid milk. Vitamin K2 helps to increase the amount of calcium deposited in bones. Exen D Plus uses the same form of Vitamin K2 (Menaquinone 7), that has been shown in recent clinical studies to help build bone density. Menaquinone 7 is considered to be the most effective form of Vitamin K, better absorbed by the body. The Vitamin K2 in Exen D Plus also helps to keep Calcium away from areas where it shouldn’t be, such as in arteries and helps to support cardiovascular health.

    Pharmacokinetics:

    Absorption: Vitamin D is readily absorbed. Maximal absorption of Calcium occurs at doses of 500mg or less taken with food. Oral bioavailability depends on intestinal pH, the presence of food and dosage.

    Protein binding: Vitamin D protein binding is 50 to 80 %. Calcium is rapidly distributed taken up by skeletal tissues following absorption and distribution into extracellular fluids. Bone contains 99% of the body’s Calcium and the remaining 1% is approximately equally distributed between intracellular and extracellular fluids.

    Metabolism: Within the liver, Cholecalciferol is hydroxylated to Calcidiol (25-hydroxycholecalciferol) by the enzyme 25 hydroxylase.

    Within the kidney, Calcidiol serves as a substrate for 1-alpha-hydroxylase, yielding Calcitriol (1, 25 dihydroxycholecalciferol), the biologically active form of Vitamin D. Calcium acts as a cofactor to numerous enzymes.

    Excretion: Calcium is eliminated in urine, faeces and sweat. The urinary Calcium excretion depends upon glomerular filtration and tubular reabsorption of Calcium. Vitamin D is eliminated via faeces and urine.

    INDICATIONS:

    Exen D is useful in case of Vitamin D and Calcium deficiency in the elderly patients. In association with some treatments of Osteoporosis (a condition where bone mass decreases and bone brittleness increases), when there is deficiency or a risk of deficiency in Vitamin D and Calcium. It may also be effective in reducing Colorectal Cancer, Hypertension and helps to diminish some of the symptoms of PMS (Premenstrual syndrome).

    Exen D Plus Tablet is indicated for: Bone mineral density, Bone health, Bone strength, to reduce the risk of Osteoporosis.

    DOSAGE AND ADMINISTRATION:

    Exen D

    Tablet: As directed by the Doctor, use 2 tablets daily (preferably with meal) for 12 years and above age group.

    Supsension: As directed by the Doctor, use 2 teaspoonful suspension twice daily (preferably with meal) for 12 years and above age group.

    Children: 2 to 5 years: 1 teaspoonful twice daily (preferably with meal). 5-12 years: 1 – 2 teaspoonful twice daily.

    DRUG INTERACTIONS:

    Cardiac gylcosides (medicines used to treat heart problems), as they may cause more side effects
    Bisphosphonates or drugs containing strontium (used in Osteoporosis)
    Thiazide diuretics (medicines used to treat high blood pressure or water retention), as they may increase the amount of Calcium in blood
    Tetracycline and Quinolone antibiotics (medicines used to treat infections due to bacteria)
    Other medicines or supplements containing Vitamin D
    Thyroid hormones used in cases of thyroid disease

    Orlistat (a medicine used to treat obesity), Ion exchange resins such as Cholestyramine or Laxatives such as Paraffin Oil, as they may reduce the amount of Vitamin D absorbed
    Corticosteroids, as they may decrease the absorption of Calcium

    You should wait at least:

    2 hours between taking Exen D/Exen D Plus and the following medicines: Medicines containing Iron or Zinc 3 hours in the event of simultaneous treatment with Tetracycline or Quinolone antibiotics (medicines used to treat infections due to bacteria) or Bisphosphonates (used in Osteoporosis)

    Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
    SIDE EFFECT:

    Constipation or stomach upset may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur:

    Nausea/vomiting, loss of appetite, unusual weight loss, mental/mood changes, change in the amount of urine, bone/muscle pain, headache, increased thirst, increased urination, weakness, tiredness, fast/pounding heartbeat. Avery serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

    Pregnancy and breastfeeding

    This medicine can be used during pregnancy and breastfeeding. However, you should not exceed the recommended dose.
    Nursing Mothers: As Calcium and Vitamin D passes into breast milk, you have to check with your doctor first if your infant receives any other products containing Vitamin D.
    Ask your doctor or pharmacist for advice before taking any medicine.

    OVER DOSE:

    These symptoms may occur: Loss of appetite, excessive thirst, feeling sick (nausea), vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental health problems, increased urine output, bone pain, kidney stones. If such effects occur, contact your doctor immediately. He/she will undertake the necessary procedures. If you take too many Exen D/Exen D Plus during a long time, Calcium deposits may appear in blood vessels or body tissues.

    STORAGE:

    Protect from light, excessive heat and moisture.
    Store in a cool & dry place below 30°C.
    Keep out of reach of children.

    DIRECTION OF RECONSTITUTION:

    Shake the bottle to loosen powder, add boiled and cool water into the bottle up to marked circle on plastic measure given inside, and shake well to make homogeneous mixture. Now again add boiled and cool water into the bottle up to marked circle on plastic measure given inside. Shake well to make a homogeneous 120ml suspension.

    PRESENTATION:

    Exen D tablet is available in a blister pack of 30’s.

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    Exen D https://glossmeup.com/product/exen-d/ https://glossmeup.com/product/exen-d/#respond Thu, 02 Sep 2021 16:25:39 +0000 https://glossmeup.com/?post_type=product&p=2442 Your bone building partner

    • Ensures Bones Health
    • Effective calcium Absorption
    • Good for Heart & Kidneys
    • Recommended for All Ages
    • Reduces Hypertension & diminishes symptoms of PMS

    More Detail About Exen D

    The post Exen D appeared first on GlossMeUp Trusted brand for Multi-Vitamins and supplements.

    ]]>
    COMPOSITION:

    Each tablet of Exen D contains:

    Calcium (Calcium from Natural Origin) …………………….500mg
    Vitamin D (Cholecalciferol from Natural Origin) …………500 IU

     

    DESCRIPTION:

    Exen D is combination product of Calcium (Calcium from Natural Origin) & Vitamin D (Cholecalciferol from Natural Origin). This combination medication is used to prevent or treat low blood Calcium levels in people who do not get enough Calcium from their diets. It may be used to treat conditions caused by low Calcium levels such as bone loss (Osteoporosis), weak bones (Osteomalacia/Rickets), decreased activity of the parathyroid gland (Hypoparathyroidism) and a certain muscle disease (Latent tetany). It may also be used in certain patients to make sure they are getting enough Calcium (e.g. women who are pregnant, nursing or postmenopausal, people taking certain medications such as Phenytoin, Phenobarbital or Prednisone). Calcium plays a vital role and is necessary for normal functioning of nerves, cells, muscles and bones. If there lack calcium in the blood, then the body consumes calcium from the bones, leading to weaker bones. Vitamin D helps body to absorb Calcium and Phosphorus, extremely essential for building and keeping strong bones.

    Exen D Plus is a special bone-building formula. It combines Vitamin K2-7, Calcium and Vitamin D all at clinically researched doses in one formulation. Just two tablets or one sachet a day of Exen D Plus is an effective way to protect against Osteoporosis and build stronger bones for the future.

    CLINICAL PHARMACOLOGY:

    Pharmacodynamics:

    Cholecalciferol (Vitamin D) is a Steroid hormone that has long been known for its important role in regulating body levels of Calcium and Phosphorus, in mineralization of bone and for the assimilation of Vitamin A. The clinical manifestations of Vitamin D deficiency are Rickets, which is seen in children and results in bone deformities including bowed long bones. Deficiency in adults leads to the disease called Osteomalacia. Both Rickets and Osteomalacia reflect impaired mineralization of newly synthesized bone matrix and usually result from a combination of inadequate exposure to sunlight and decreased dietary intake of Vitamin D. Common causes of Vitamin D deficiency include genetic defects in the Vitamin D receptor, severe liver or kidney disease and insufficient exposure to sunlight. Vitamin D plays an important role in maintaining Calcium balance and in the regulation of Parathyroid hormone (PTH). It promotes renal reabsorption of Calcium, increases intestinal absorption of Calcium and Phosphorus and increases Calcium and Phosphorus mobilization from bone to plasma.

    Calcium carbonate acts by directly increasing Calcium stores within the body. Calcium (Caz‘) plays a vital role in the physiology and biochemistry of organisms and the cell. It plays an important role in signal transduction pathways, where it acts as a second messenger in neurotransmitter release from neurons, contraction of all muscle cell types and fertilization. Many enzymes require Calcium ions as a cofactor, those of the blood clotting cascade being notable examples. Extracellular Calcium is also important for maintaining the potential difference across excitable cell membranes, as well as proper bone formation.

    Pharmacology:

    Vitamin D is produced in the skin by photochemical conversion of 7-dehydrocholesterol to pre-vitamin D by ultraviolet light. This is followed by non-enzymatic isomerization to Vitamin D. In the absence of adequate sunlight exposure, Vitamin D is an essential dietary nutrient. Vitamin D in skin is converted to 25—hydroxyvitamin D in the liver. Conversion to the active Calcium—mobilizing hormone 1,25— dihydroxyvitamin D (Calcitriol) in the kidney is stimulated by both Parathyroid hormone and Hypophosphatemia. The principal action of 1,25-dihydroxyvitamin D is to increase intestinal absorption of both Calcium and Phosphate as well as regulate serum Calcium, renal Calcium and Phosphate excretion, boneformation and bone resorption.

    Vitamin D is required for normal bone formation. Vitamin D insufficiency develops when both sunlight exposure and dietary intake are inadequate. Insufficiency is associated with negative Calcium balance, increased Parathyroid hormone levels, bone loss and increased risk of skeletal fracture. In severe cases, deficiency results in more severe hyperparathyroidism, hypophosphatemia, proximal muscle weakness, bone pain and osteomalacia. The first step involved in the activation of Vitamin D is a 25-hydroxylation which is catalysed by the 25-hydroxylase in the liver and then by other enzymes. The mitochondrial sterol 27-hydroxylase catalyses the first reaction in the oxidation of the side chain of sterol intermediates. The active form of Vitamin D (Calcitriol) binds to intracellular receptors that then function as transcription factors to modulate gene expression. Like the receptors for other steroid hormones and thyroid hormones, the Vitamin D receptor has hormone-binding and DNA-binding domains. The Vitamin D receptorforms a complex with another intracellular receptor, the retinoid-X receptor, and that heterodimer is what binds to DNA. In most case studieds, the effect is to activate transcription, but situations are also known in which Vitamin D suppresses transcription.

    Calcitriol increases the serum Calcium concentrations by:

    Increasing GI absorption of Phosphorus and Calcium, increasing osteoclastic resorption and increasing distal renal tubular reabsorption of Calcium. Calcitriol appears to promote intestinal absorption of Calcium through binding to the Vitamin D receptor in the mucosal cytoplasm ofthe intestine. Subsequently, Calcium is absorbed through formation of a Calcium-binding protein. Calcium exist in bones in the form of hydroxyapatite. Hydroxyapatite comprises of approximately 40% of the weight of the bone. Exen D/Exen D Plus has been found to reduce colonic mucosal proliferation Calcium ions may precipitate bile acids and fatty acids that can stimulate the proliferation of colon cells. Exen D/Exen D Plus has been found to have the modest effect on the reduction of systolic blood pressure in those with hypertension. Diastolic pressure does not appear to be affected by Calcium. More than 500 human proteins are known to bind or transport Calcium. The skeleton acts as a major mineral storage site for the element and releases Ca” ions into the bloodstream under controlled conditions. Circulating Calcium is either in the free, ionized form or bound to blood proteins such as serum Albumin. Parathyroid hormone (secreted from the parathyroid gland) regulates the resorption of Ca” from bone. Calcitonin stimulates incorporation of Calcium in bone, although this process is largely independent of calcitonin. Although Calcium flow to and from the bone is neutral, about 5 mmol is turned over a day. Bone serves as an important storage point for Calcium, as it contains 99% of the total body Calcium. Low Calcium intake may also be a risk factor in the development of Osteoporosis.The currently recommended Calcium intake is 1,500 milligrams per day for women not taking Estrogen and 800 milligrams per day for women on Estrogen. There is close to 300 milligrams of Calcium in one cup of fluid milk. Vitamin K2 helps to increase the amount of calcium deposited in bones. Exen D Plus uses the same form of Vitamin K2 (Menaquinone 7), that has been shown in recent clinical studies to help build bone density. Menaquinone 7 is considered to be the most effective form of Vitamin K, better absorbed by the body. The Vitamin K2 in Exen D Plus also helps to keep Calcium away from areas where it shouldn’t be, such as in arteries and helps to support cardiovascular health.

    Pharmacokinetics:

    Absorption: Vitamin D is readily absorbed. Maximal absorption of Calcium occurs at doses of 500mg or less taken with food. Oral bioavailability depends on intestinal pH, the presence of food and dosage.

    Protein binding: Vitamin D protein binding is 50 to 80 %. Calcium is rapidly distributed taken up by skeletal tissues following absorption and distribution into extracellular fluids. Bone contains 99% of the body’s Calcium and the remaining 1% is approximately equally distributed between intracellular and extracellular fluids.

    Metabolism: Within the liver, Cholecalciferol is hydroxylated to Calcidiol (25-hydroxycholecalciferol) by the enzyme 25 hydroxylase.

    Within the kidney, Calcidiol serves as a substrate for 1-alpha-hydroxylase, yielding Calcitriol (1, 25 dihydroxycholecalciferol), the biologically active form of Vitamin D. Calcium acts as a cofactor to numerous enzymes.

    Excretion: Calcium is eliminated in urine, faeces and sweat. The urinary Calcium excretion depends upon glomerular filtration and tubular reabsorption of Calcium. Vitamin D is eliminated via faeces and urine.

    INDICATIONS:

    Exen D is useful in case of Vitamin D and Calcium deficiency in the elderly patients. In association with some treatments of Osteoporosis (a condition where bone mass decreases and bone brittleness increases), when there is deficiency or a risk of deficiency in Vitamin D and Calcium. It may also be effective in reducing Colorectal Cancer, Hypertension and helps to diminish some of the symptoms of PMS (Premenstrual syndrome).

    Exen D Plus Tablet is indicated for: Bone mineral density, Bone health, Bone strength, to reduce the risk of Osteoporosis.

    DOSAGE AND ADMINISTRATION:

    Exen D

    Tablet: As directed by the Doctor, use 2 tablets daily (preferably with meal) for 12 years and above age group.

    Supsension: As directed by the Doctor, use 2 teaspoonful suspension twice daily (preferably with meal) for 12 years and above age group.

    Children: 2 to 5 years: 1 teaspoonful twice daily (preferably with meal). 5-12 years: 1 – 2 teaspoonful twice daily.

    DRUG INTERACTIONS:

    Cardiac gylcosides (medicines used to treat heart problems), as they may cause more side effects
    Bisphosphonates or drugs containing strontium (used in Osteoporosis)
    Thiazide diuretics (medicines used to treat high blood pressure or water retention), as they may increase the amount of Calcium in blood
    Tetracycline and Quinolone antibiotics (medicines used to treat infections due to bacteria)
    Other medicines or supplements containing Vitamin D
    Thyroid hormones used in cases of thyroid disease

    Orlistat (a medicine used to treat obesity), Ion exchange resins such as Cholestyramine or Laxatives such as Paraffin Oil, as they may reduce the amount of Vitamin D absorbed
    Corticosteroids, as they may decrease the absorption of Calcium

    You should wait at least:

    2 hours between taking Exen D/Exen D Plus and the following medicines: Medicines containing Iron or Zinc 3 hours in the event of simultaneous treatment with Tetracycline or Quinolone antibiotics (medicines used to treat infections due to bacteria) or Bisphosphonates (used in Osteoporosis)

    Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
    SIDE EFFECT:

    Constipation or stomach upset may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur:

    Nausea/vomiting, loss of appetite, unusual weight loss, mental/mood changes, change in the amount of urine, bone/muscle pain, headache, increased thirst, increased urination, weakness, tiredness, fast/pounding heartbeat. Avery serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

    Pregnancy and breastfeeding

    This medicine can be used during pregnancy and breastfeeding. However, you should not exceed the recommended dose.
    Nursing Mothers: As Calcium and Vitamin D passes into breast milk, you have to check with your doctor first if your infant receives any other products containing Vitamin D.
    Ask your doctor or pharmacist for advice before taking any medicine.

    OVER DOSE:

    These symptoms may occur: Loss of appetite, excessive thirst, feeling sick (nausea), vomiting, constipation, abdominal pain, muscle weakness, fatigue, mental health problems, increased urine output, bone pain, kidney stones. If such effects occur, contact your doctor immediately. He/she will undertake the necessary procedures. If you take too many Exen D/Exen D Plus during a long time, Calcium deposits may appear in blood vessels or body tissues.

    STORAGE:

    Protect from light, excessive heat and moisture.
    Store in a cool & dry place below 30°C.
    Keep out of reach of children.

    DIRECTION OF RECONSTITUTION:

    Shake the bottle to loosen powder, add boiled and cool water into the bottle up to marked circle on plastic measure given inside, and shake well to make homogeneous mixture. Now again add boiled and cool water into the bottle up to marked circle on plastic measure given inside. Shake well to make a homogeneous 120ml suspension.

    PRESENTATION:

    Exen D tablet is available in a blister pack of 30’s.

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