BETERCAL-K2 7 Softgel Capsules
Calcium Citrate maleate 500mg + Boron 1.5mg + Methylcobalamin 750mcg + Folic Acid 400mcg + Vitamin K2
7 — 45mcg + Calcitriol 0.25mcg
This formulation combines Calcitriol, calcium and Zinc.
Calcitriol is important for the absorption of calcium from the stomach and for the functioning of calcium in
the body. The known sites of action of Calcitriol are intestine, bone, kidney and parathyroid gland. In bone,
Calcitriol in conjunction with parathyroid hormone stimulates resorption of calcium; and in the kidney,
calcitriol increases the tubular reabsorption of calcium.
Calcium plays a critical role in the body. It is essential for normal functioning of nerves, cells, muscle and bone.
Calcium prevents bone loss and is associated with a modest reduction in fracture risk. Calcium and vitamin D
preparations are used to prevent or to treat calcium deficiency.
Adequate Zinc is required for normal growth and tissue repair. Urinary elimination of Zinc is increased in
osteoporotic women. Zinc depletion is shown to diminish the response of oral VIT. D 3 when administered
orally. Supplementary Zinc not only improves VIT. D 3 response but also helps to arrest bone loss in old
ROLE OF VITAMIN K2 (MENAQUINONE 7) IN OSTEOPOROSIS
Vitamin K was originally discovered as the anti-hemorrhagic factor, but it now encompasses a variety of
physiological processes. The major source of vitamin K in most diets is phylloquinone (vitamin K1), which is
present in green leafy vegetables such as spinach, broccoli, and kale. Vitamin K2 is present in small amounts in
fermented foods, milk products, cheese, and meat, and is synthesized by various human gut microbiota. It is
well documented that the Western population obtains insufficient vitamin K from their regular diets, possibly
related to poor absorption from these foods.
Beyond blood clotting, the role of vitamin K in osteoporosis and cardiovascular disease is related to calcium
utilization. Scientific studies have revealed that vitamin K plays a crucial role in building and maintaining bone
health, which is influenced by osteoblasts, osteoclasts, hormones, cytokines and nutritional factors, including
vitamin K intake. Inadequate calcium metabolism can result in cardiovascular and bone health problems. The
deposition of calcium into arteries is an organized, regulated process similar to bone formation that occurs
when other factors are present. Proteins like osteocalcin and matrix Gla protein, which are actively involved in
the transport of calcium out of vessel walls, are suspected to have key roles in coronary calcium deposition.
The greater the amount of calcification, the greater the likelihood one may develop suboptimal coronary
health. Additionally, research shows undercarboxylated osteocalcin and low vitamin K intakes are risk factors
for fractures in women. Vitamin K is needed to activate osteocalcin (carboxylated), which functions to take
calcium out of the vessels and deposit them into the bones. Therefore, consuming sufficient amounts of
dietary calcium is not enough for bone and cardiovascular health; the body needs to distribute and utilize the
calcium properly with aid of Vitamin K.
Vitamin K2 (as MK-7) is more bioactive and has proven more effective than vitamin K1 and other
menaquinones. MK-7 showed eight times the half-life of vitamin K1 in a 24-hour serum concentration level
after 1 mg of each form was ingested. Thus, MK-7 can be administered in low dosages only once a day,
typically 1/1000 that of a MK-4 dose. Furthermore, the study showed better utilization and improved
osteocalcin carboxylation for MK-7 after 6 weeks. Numerous studies reveal long-chain menaquinones, such
as MK-7 are more effective in supporting arterial health than vitamin K1 menaquinones.
Betercal is indicated in
i.) Management of hypocalcaemia in patients undergoing dialysis for chronic renal failure. It has been shown
to significantly reduce elevated parathyroid hormone (PTH) levels. Reduction of PTH has been shown to
result in an improvement in renal osteodystrophy
ii.) Post-menopausal osteoporosis.
iii.) Hypocalcaemia in hypoparathyroidism
v.) Vitamin D dependent rickets
vi.) Renal tubular osteocalcaemia
vii.) Sporadic and oncogenic hypophosphatemic osteomalacia
viii.) X-linked hypophosphatemic osteomalacia
ix.) Osteomalacia in Malabsorption syndrome
x.) Hypocalcaemia and hypomagnesaemia after small bowel resection
xi.) Osteoporosis in males
DOSAGE AND ADMINISTRATION
The optimal dose must be carefully determined for each patient. The recommended initial dose is one capsule
of Betercal daily. If a satisfactory response in the biochemical parameters and clinical manifestations of the
disease state is not observed, the dose may be increased by an increment of 1-2 caps at two to four week
intervals. In patients undergoing dialysis, the dose may be increased by an increment of 1 cap at 4 to 8 – week
intervals. During this titration period, serum calcium and phosphorus levels should be obtained at least twice
weekly and if hypercalcaemia is noted, the drug should be immediately discontinued until normocalcaemia
ensues. In patients undergoing dialysis, phosphorus magnesium and alkaline phosphatase should be
determined periodically. Patients should be informed the symptoms of hypercalcaemia.