Shelcal (Calcium Carbonate + Cholecalciferol (Vitamin D3))
Also sold as: Shelcal, Calcirol, Cipcal, Oscal, Macal
Pregnancy
Cat A
Lactation
Safe
Schedule
OTC
Forms
Tablet: Calcium 500mg (as carbonate) + D3 250 IU +4
Indications
- Calcium and vitamin D deficiency (prevention and treatment)
- Osteoporosis (combined with antiresorptive therapy — bisphosphonates, denosumab)
- Osteomalacia / rickets (nutritional)
- Hypoparathyroidism
- Post-thyroidectomy hypocalcaemia
- Pregnancy and breastfeeding (increased calcium/D3 requirements)
- Long-term corticosteroid therapy (bone protection)
Adult Dosing
Calcium + D3 deficiency / general supplementation
Calcium 500–1000 mg elemental calcium daily + D3 400–1000 IU daily
Split dose (< 500 mg elemental calcium per dose for optimal absorption). Total dietary + supplemental calcium 1000–1200 mg/day for adults.
Osteoporosis (with antiresorptive)
Calcium 1000–1500 mg elemental/day + D3 800–2000 IU/day
Ongoing — as long as antiresorptive therapy continues
Vitamin D deficiency treatment
D3 1000–4000 IU/day for 8–12 weeks, then maintenance 800–1000 IU/day
Severe deficiency (25-OH-D < 12 ng/mL): loading doses may be needed — 50,000 IU/week × 8 weeks (separate cholecalciferol preparation)
Pediatric Dosing
Breastfed infants: D3 400 IU/day supplement from birth. Rickets: 1000–4000 IU/day under supervision.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| eGFR < 30 mL/min | Use with caution — risk of hypercalcaemia and vascular calcification. Monitor serum calcium, phosphate, and PTH closely. Specialist supervision. |
Hepatic Adjustment
No dose adjustment for calcium. D3 hydroxylation (first step) occurs in liver — severe hepatic disease may impair D3 activation; calcidiol (25-OH-D3) may be preferable.
Pregnancy & Lactation
Pregnancy: Category A
Safe and necessary in pregnancy — recommended daily allowance increases to 1000–1200 mg calcium + 600–800 IU D3. Deficiency increases risk of pre-eclampsia, low birth weight, neonatal rickets. WHO recommends 1.5–2 g elemental calcium/day in areas with low dietary calcium intake (including India) to prevent pre-eclampsia.
Lactation: Safe
Safe and recommended during breastfeeding — increases to 1000 mg calcium + 600 IU D3/day. Breast milk D3 content is low — breastfed infants need D3 drops.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Bisphosphonates (alendronate, risedronate) | Calcium interferes with bisphosphonate absorption — take bisphosphonate on empty stomach (separate from calcium by at least 30 minutes) | Moderate |
| Levothyroxine | Calcium reduces thyroid hormone absorption — separate by at least 4 hours | Moderate |
| Iron supplements | Calcium impairs iron absorption — separate doses by 2–4 hours | Moderate |
| Fluoroquinolones, tetracyclines | Calcium chelates antibiotics — reduces antibiotic absorption; separate by 2–4 hours | Moderate |
| Thiazide diuretics | Increase calcium reabsorption — risk of hypercalcaemia with high calcium intake | Moderate |
| Digoxin | Hypercalcaemia increases digoxin toxicity risk — monitor calcium levels | Major |
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Side Effects
Common
- Constipation (most common — calcium carbonate more than citrate)
- Flatulence and bloating
- Nausea
- Hypercalciuria (increased urinary calcium — stone risk with very high doses)
- Taste disturbance (chalky taste)
Serious / Discontinue If
- Hypercalcaemia (nausea, constipation, polyuria, confusion — especially with vitamin D toxicity; excess supplementation)
- Kidney stones (increased urinary calcium — especially in susceptible individuals; ensure adequate water intake)
- Milk-alkali syndrome (excessive calcium + alkali — hypercalcaemia, alkalosis, renal impairment — rare now)
- Vascular calcification (in CKD patients with high calcium load)
Contraindications
- Hypercalcaemia (any cause)
- Hypercalciuria (idiopathic, stone-forming)
- Severe renal failure with high phosphate (uncontrolled hyperphosphataemia)
- Vitamin D toxicity
- Sarcoidosis and granulomatous diseases (increased D3 sensitivity — risk of hypercalcaemia)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Shelcal 500 (Ca 500mg + D3 250 IU) | Elder Pharma | 30 tab ₹148 |
| Shelcal HD (Ca 1250mg + D3 1000 IU) | Elder Pharma | 30 tab ₹265 |
| Cipcal 500 (Ca 500mg + D3 250 IU) | Cipla | 30 tab ₹145 |
| Calcirol-D3 (Ca 500mg + D3 500 IU) | Cadila | 30 tab ₹135 |
| Macal (Ca 500mg + D3 500 IU) | Macleods | 30 tab ₹125 |
Monitoring Required
- Serum calcium (baseline; if symptoms of hypercalcaemia)
- Serum 25-OH-vitamin D (baseline and after 3 months of treatment)
- PTH levels (osteoporosis management)
- Urinary calcium (24-hour — if stone history)
- Serum creatinine/eGFR (CKD patients)
- Renal USS (if stone symptoms)
Patient Counseling Points
- Take calcium supplements with meals (carbonate requires acid for absorption — food stimulates acid production)
- Drink plenty of water — at least 2 litres/day to prevent kidney stones
- Take thyroid tablets (levothyroxine), iron tablets, or bisphosphonate 2–4 hours apart from calcium
- Constipation is common — increase fibre and water; calcium citrate (instead of carbonate) causes less constipation
- Do not exceed prescribed dose — too much vitamin D is harmful (vitamin D toxicity)
- Get some sunlight (10–15 minutes/day of sun exposure) — natural vitamin D synthesis
- Continue calcium and D3 throughout bisphosphonate therapy — do not stop
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EasyClinic auto-flags Shelcal interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Suresh Menon, DM (Endocrinology), Consultant Endocrinologist
Last reviewed: 2026-04-01
References
- ICMR RDA for Calcium and Vitamin D 2020
- IOF Osteoporosis Guidelines 2022
- WHO Calcium Supplementation in Pregnancy
- BNF — Calcium + Vitamin D
- Endocrine Society D3 Guidelines 2011