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Calcium Citrate and Vitamin D in the Treatment of Osteoporosis

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Abstract

The combination of calcium with vitamin D (vitamin D3 [colecalciferol]) forms the basis of preventive and therapeutic regimens for osteoporosis. A number of studies have suggested that the combination of calcium and vitamin D is effective when administered at respective dosages of at least 1200 mg and 800IU per day, although efficacy is, as expected, affected by patient compliance. Overall, treatment with this combination appears to be effective in reducing the incidence of non-vertebral and hip fractures. Also, in all drug studies (of antiresorptive and anabolic agents and strontium ranelate) that demonstrated a reduction in risk of osteoporotic fractures, patients also took calcium and vitamin D supplements. An important finding in this regard is that vitamin D levels have been demonstrated to be inadequate in more than half of women treated for osteoporosis in the US and Europe.

The capacity of the small intestine to absorb calcium salts depends on the solubility and ionization of the salts. These properties vary for different salts, with fasting calcium citrate absorption being greater than that of calcium lactogluconate and calcium carbonate. Calcium citrate formulations taken between meals may help to prevent abdominal distension and flatulence, as well as minimize the risk of renal calculus formation, thus helping to optimize patient compliance. Therefore, calcium citrate combined with vitamin D is the combination of choice for the prevention or treatment of osteoporosis.

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Acknowledgements

Editorial assistance was provided by Andrea Bothwell and Soledad Santos of inScience Communications, a Wolters Kluwer Business, with funding provided by Warner Chilcott. The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Mineral Metabolism Unit, Hospital Universitario Reina Sofía, Córdoba, Spain

    José Manuel Quesada Gómez

  2. IMAS Rheumatology Department, Hospital Universitario Reina Sofía, Córdoba Avda. Menéndez Pidal s/n, 14004, Córdoba, Spain

    Josep Blanch Rubió

  3. Department of Internal Medicine/Bone Metabolism Disorders, Fundación Jiménez Díaz, Madrid, and Bone Metabolism Disorders, Universidad Autónoma, Madrid, Spain

    Manuel Díaz Curiel

  4. Department of Internal Medicine and Infectious Diseases, Hospital del Mar-IMIM, Universidad Autónoma de Barcelona, Barcelona, Spain

    Adolfo Díez Pérez

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Gómez, J.M.Q., Rubió, J.B., Curiel, M.D. et al. Calcium Citrate and Vitamin D in the Treatment of Osteoporosis. Clin. Drug Investig. 31, 285–298 (2011). https://doi.org/10.1007/BF03256927

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