Conflicting advice on when to take Accrete D3 (colecalciferol) supplements

Posted , 14 users are following.

Many people on prednisolone are also taking Accrete D3 tablets. My mum's pharmacist told her to take this 1 hour before foor or two hours after food TWICE a day which can be a pain in the a*** to calculate the timings on some days.

However, recent reading up on Google suggests we may have been doing this wrong as other reputable sites state that it should be taken just before or just after a meal so now I am completely confused !

Sources:

http://www.ouh.nhs.uk/patient-guide/leaflets/files/11732Palendronic.pdf

https://patient.info/medicine/calcium-with-colecalciferol

0 likes, 25 replies

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  • Posted

    I'd say the pharmacist is really rather over-egging his advice and not considering that when to take tablets must be simple when patients are on several medications - and he hasn't read the manufacturer's advice! After all, you'd think THEY might know how they want their product used.

    I have looked up the manufacturer's data sheet for Accrete. It says:

    "Tablets should be swallowed (without chewing) with water or fruit juice, ideally within an hour and a half after meals. The tablet can be broken in half, if needed."

    i.e. it should be taken when there is some food in the stomach - this reduces the risk of the gastric side effects which do affect some people, and means there should be some fat present to transport the vit D and calcium from the gut into the bloodstream.

    Other dietary aspects are oxalate-containing foods: "Oxalic acid (found in e.g. spinach, sorrel and rhubarb) and phytic acid (found in whole cereals) may reduce calcium absorption. The patient should not take Accrete D3 film-coated tablets within two hours after eating foods rich in oxalic acid and phytic acid."

    Otherwise there is no dietary information.

    It tells you to ask for advice if on certain other medications - including corticosteroids - but that is probably because you shouldn't take corticosteroids and calcium within a couple of hours of each other. So the sensible approach has already been mentioned: pred for breakfast (or earlier) and calcium/vit D soon after lunch and another meal. 

    • Posted

      I've read the same thing Eileen but the label typed by the pharmacist that is stuck onto the box states otherwise

    • Posted

      But what I'm saying is that the datasheet trumps the pharmacists personal opinion - and they have said the exact opposite of the manufacturers who want it to be taken WITHIN less than 2 hours after a meal. And that certainly fits with every other data sheet for calcium/vit D I have read (and I have read a few).

      Personally I take my chewable calcium/vit D tablets when I think about them - and in 7 years on pred and only taking calcium/vit D for "bone protection" there has been only a minimal change in my bone density. Must be doing something right!!!!!

    • Posted

      I have a similar experience but then I wondered if it is also our inherited genes and our lack of predisposition to bone loss, as well as our lack of other disease.   My sister has Lupus and now is really suffering with bone loss and other complications.  Of course she took prednisone very early in her life. I think the two of us possess different DNA. 
    • Posted

      As always we can rely on Eileen for the facts !  

      I concur above, use my mob to nudge me into taking at the right time. One thing I notice though, is a cloudy, high ph (alkaline) wee,  at least daily (It is not infected).  I presume I am excreting excess calcium and do rather hope it is not clogging my arteries...anyone else get this?  

    • Posted

      Yes I get what you're saying Eileen only that it's a real kicker that my mum has been on the Accrete D3 for over 3 months and I've had to choreograph her breakfast and dinner times to accommodate her taking the tablet within the advised time frames. To now know that all this has been unnecessary is frustrating to say the least.

       

    • Posted

      Well yes, totally agree. So it comes down to "do your own research"...

      But while I would always encourage asking the pharmacist when a doctor is unclear, the data sheet trumps both! Unless there is a special situation that makes their instruction a problem. In the case of calcium/vit D the only thing that really matters is "don't take it at the same time as pred and keep your intake of rhubarb, spinach and sorrel to a minimum" Though to be honest - the exact amount of calcium/vit D is not particularly important, some will always get through and you should be taking an excess. 

    • Posted

      Yes - similar problem, especially on days I don't drink as much as usual. If it is in your pee it shouldn't be in your arteries wink

    • Posted

      Trouble with me, if you remember, I just took what I was given as 'just in case' when first diagnosed and ended up with Pseudo-Gout,  cause excess calcium. Nobody had checked if I needed it and I did not.  From that time on, I became wary.  But then I met you and learned.

  • Posted

    I look forward to other responses.  I've never heard of this.

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