Citracalpro.com answers the questions that patients commonly ask about calcium, CITRACAL^® products, and more.

• General calcium FAQs
• Product-specific FAQs
  • CITRACAL MAXIMUM
  • CITRACAL PLUS BONE DENSITY BUILDER
  • CITRACAL SLOW RELEASE 1200
  • CITRACAL CALCIUM GUMMIES

How much calcium do my patients need?

According to the Institute of Medicine (IOM), the daily calcium dietary allowances in milligrams are as follows¹:

Source: Institute of Medicine, Dietary Reference Intakes for Calcium.

In addition to IOM recommendations, CITRACAL meets other key recommendations as well. The National Institutes of Health, the National Osteoporosis Foundation, and the American Congress of Obstetricians and Gynecologists all recommend that women who are aged 51+ get 1200 mg of calcium per day.^2-4

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How much Vitamin D do my patients need?

According to the Institute of Medicine (IOM), the daily Vitamin D dietary allowances in international units (IU) are as follows¹:

Source: Institute of Medicine, Dietary Reference Intakes for Calcium.

In addition to IOM recommendations, CITRACAL meets other key recommendations as well. The National Osteoporosis Foundation recommends that adults who are aged 50+ get 800 to 1000 IU of Vitamin D per day³.

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Does CITRACAL contain gluten?

CITRACAL does not add any gluten to our line of products. However, we cannot guarantee that they are 100% gluten free, as they are produced in a facility that manufactures or packages other items that may contain gluten.

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Does CITRACAL contain lactose?

Lactose is not used in our formulas. Furthermore, our ingredient suppliers have confirmed that none of the ingredients used in these formulas are derived from lactose

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CITRACAL MAXIMUM

What is the difference between calcium citrate and calcium carbonate?

There are several differences between calcium citrate and calcium carbonate. They include

• Calcium citrate is a water-soluble calcium salt, so it is not dependent on gastric acid for its absorption. Calcium carbonate requires gastric acid for its absorption⁵
• Calcium citrate can be taken in conjunction with acid-reducing agents, such as proton pump inhibitors, whereas the absorption of calcium carbonate can be negatively impacted by concomitant use of these products^6-8

My patients have difficulty swallowing tablets. Does CITRACAL come in a smaller pill?

CITRACAL offers a diverse product line in tablets. CITRACAL PETITES are the smallest tablets in the CITRACAL product line. One serving (2 tablets) contains 400 mg of calcium citrate and 500 IU of Vitamin D₃.

For patients who prefer a supplement in an alternate form, CITRACAL CALCIUM GUMMIES are great tasting, soft, and easy to chew. Each serving contains 500 mg of tricalcium phosphate and 500 mg of Vitamin D₃.

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What are the possible side effects of CITRACAL?

In general, this product is well tolerated and easy on the digestive system.

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CITRACAL PLUS BONE DENSITY BUILDER

How does genistein relate to bone health?

As a selective estrogen receptor modulator, genistein has been shown to positively regulate bone cell metabolism.^9*

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Were any side effects noted in studies with genistein?

In the study conducted by Marini et al, no serious adverse events were reported. There were gastrointestinal events, which included abdominal pain, constipation, dyspepsia, epigastric pain, and vomiting.⁹

As with all products containing soy isoflavones, caution should be exercised when recommending this product to patients who are pregnant, are nursing, or have a history of cancer.

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Is CITRACAL PLUS BONE DENSITY BUILDER a replacement for bisphosphonates?

No.

Do patients need to take calcium and Vitamin D along with CITRACAL PLUS BONE DENSITY BUILDER?

No, 2 tablets taken twice daily with food provide a total of 1200 mg of calcium, 800 IU of Vitamin D₃, plus 54 mg of genistein.

Suggest that your patients visit the CITRACAL consumer Web site at www.citracal.com.

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CITRACAL SLOW RELEASE 1200

How is once-daily CITRACAL SLOW RELEASE 1200 different?

CITRACAL SLOW RELEASE 1200 is the only^† once-daily calcium supplement. Just 1 dose taken with food (2 tablets) provides 1200 mg of calcium plus 1000 IU of Vitamin D₃.

^†Among leading brands.

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What is the science behind CITRACAL SLOW RELEASE 1200?

Slo-Cal™ Technology releases calcium slowly and continuously for efficient absorption, so patients can take just 1 dose a day to meet their daily requirements. In a clinical study, total serum calcium concentration (AUC) over the 24 hours for single dose administration for CITRACAL SLOW RELEASE 1200 was comparable (maintained levels just above base line) to the 3 groups which were dose twice per day.¹¹ Additionally, 24-hour urine excretion levels of calcium were significantly lower with CITRACAL SLOW RELEASE 1200 than with Os-Cal^® and Caltrate^® .¹²

Os-Cal is a registered trademark of GlaxoSmithKline.
Caltrate is a registered trademark of Pfizer, Inc.

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CITRACAL CALCIUM GUMMIES

My patients sometimes have trouble swallowing pills. What other options do they have?

CITRACAL CALCIUM GUMMIES are ideal for patients who may not be able to swallow pills or who want an alternate form.

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How much calcium and Vitamin D₃ do CITRACAL CALCIUM GUMMIES contain?

Each serving (2 Gummies) contains 500 mg of calcium in the form of tricalcium phosphate and 500 IU of Vitamin D3. The recommended daily dose is 1 serving twice a day with food.

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How can I learn more about CITRACAL?

To learn more about these and other CITRACAL products, call 1-800-94BAYER and speak with a Bayer representative.

References: 1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy of Sciences; November 2010. 2. Calcium quickfacts. National Institutes of Health, Office of Dietary Supplements Web site. http://ods.od.nih.gov/pdf/factsheets/Calcium-QuickFacts.pdf. Published November 2010. Accessed February 15, 2011. 3. Calcium: what you should know. National Osteoporosis Foundation Web site. http://www.nof.org/aboutosteoporosis/prevention/calcium. Published 2010. Accessed February 15, 2011. 4. What is osteoporosis? American Congress of Obstetricians and Gynecologists Web site. http://www.acog.org/publications/patient_education/bp048.cfm. Published December 2007. Accessed February 15, 2011. 5. Recker RR. Calcium absorption and achlorhydria. N Engl J Med. 1985;313:70-73. 6. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296:2947-2953. 7. Pak CYC. Bioavailability of calcium from different salts. Pharmacy Times. 1989;Jan:42-44. 8. Straub DA. Calcium supplementation in clinical practice: a review of forms, doses, and indications. Nutr Clin Pract. 2007;22:286-296. 9. Marini H, Minutoli L, Polito F, et al. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial. Ann Intern Med. 2007;146:839-847. 10.-11. Data on file. CITRACAL study. Bayer HealthCare LLC.

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