Cacit® Vitamina D3 1000 mg/880 U.I.

Indications (from package insert):

This drug is used to treat calcium and vitamin D deficiency in older people. It is also used in combination with therapies for osteoporosis in patients with deficiency or at high risk for concomitant vitamin D and calcium deficiency.

Ingredients:

Active Ingredients: Calcium carbonate 2500 mg ( 1000 mg calcium or 25 mmol), Cholecalciferol 880 I.U. ( 22µg Vitamin D3).

Excipients: Citric acid, malic acid, gluconolactone, maltodextrin, sodium cyclamate, sodium saccharinate, lemon flavor (containing: sorbitol, mannitol, D-gluconolactone, dextrin, gum arabic, lemon essence), rice starch, potassium carbonate, α-tocopherol, hydrogenated soybean oil, gelatin, sucrose, corn starch.

The package contains 30 8 g sachets of white effervescent granules for oral solution.

Let's review the ingredients in order of quantity as per the label.

Carbonato di calcio. Indicated as a treatment in cases of calcium deficiency in elderly subjects and in combination with therapies for osteoporosis.

Vitamina D₃.It is indicated to help: dry eye disease and eye inflammation, weight loss, prophylaxis in patients with benign prostatic hyperplasia, pregnancy, type 1 diabetes

Acido citrico. It is a tricarboxylic acid and is obtained from lemon juice and other fruits, beet juice and other vegetables and is used as an excipient in pharmaceuticals, as an anticoagulant in medicine.

Acido malico. It is a dicarboxylic acid found in unripe fruits and produces a pleasant acidic taste. It is also found in the human body, in citric acid, and is used by the food industry to impart an acidic taste to foods.

Gluconolattone.  It is a natural polyhydroxy acid produced by enzymatic oxidation from D-glucose and has a scavenging capacity in free radicals with a strong antioxidant action. It has also demonstrated moisturizing and chelating activity and is commonly used in cosmetics, medicine and in the food industry as an acidifying, chelating, leavening or, as in the case of tofu processing, coagulating agent.

Maltodestrina. It is used as an additive in the food industry to sweeten foods. More digestible than other carbohydrates, it is a white powder that provides only 4 calories per gram and low amounts of fiber, fat and protein. It also has a preservative function.

Sodio ciclamato is a chemical compound, sodium salt of cyclamic acid, used as a non-nutritive sweetener. The results of some scientific studies suggest that sodium cyclamate may seriously inhibit osteoblast proliferation and differentiation and may cause DNA damage.

Il sodio saccarinato is a salt of saccharin and is used like saccharin since it is, on the practical side, the same component It is used extensively by the food industry as a sweetener in baked goods, jams, canned fruit, candies, chewing gum. It is also used in cosmetics and pharmaceuticals. As for other sweeteners, the field of scientific research is full of studies about its food safety.

L'amido di riso has countless applications in the food sector: it has no gluten, high nutritional value, excellent digestibility. Rice has also demonstrated anti-tumor properties. It is also added in pharmaceutical formulations as a thickener.

Potassio carbonato or potassium bicarbonate. It is commonly used in medicine as an antacid and in the treatment of gastroesophageal reflux.It also possesses antifungal properties.

Vitamina E o α-tocoferolo.The term α-tocopherol does not refer to a single substance, but to eight different isomers, but they perform the same function. Vitamin E is the most important fat-soluble antioxidant. Its antioxidant action has effects on the brain, when in the cardiovascular system there are problems of diabetes caused by LDL cholesterol and in liver diseases.

Olio di semi di soia hydrogenated. It is among the most widely used edible oils in the world and is rich in polyunsaturated and monounsaturated fatty acids, a mixture of triglycerides consisting of five long-chain fatty acids particularly linolenic acid, linoleic acid and oleic acid. The hydrogenation process in all oils takes away many of their health properties. On the other hand, in this package the amounts are minimal.

Gelatina is a protein material derived from natural collagen.The main raw materials used in the production of gelatin are cattle bones, cow hides and pig skins. Several alternative sources include poultry and fish. Foreign substances, such as minerals (in the case of bone), fats and albuminoids (found in the skin), are removed by chemical and physical treatment to give a purified collagen. These pretreated materials are then hydrolyzed into gelatin, which is soluble in hot water. It is a gelling agent.

Saccarosio is a synonym for common sugar.  It's at the bottom of the list, so in minimal amounts.

Amido di mais. It is obtained by grinding corn or maize usually of its central part or kernel, as opposed to corn flour where the whole cob is ground and it is commonly used by food and cosmetic industry. It is gluten free and is a thickener. Last on the list therefore in minimum quantity.

Conclusions.

I was prescribed this to fortify my bones, but given the presence of sodium cyclamate, I asked my physician for an alternative medication.

Frankly, the presence of a decidedly "unhealthy" ingredient that could therefore cause health problems in a medicine is surprising. The only explanation maybe is the dated formulation and not updated with recent studies. On the other hand, unfortunately, until the ingredient (see also Titanium Dioxide banned in some European countries but not yet in Italy and yet present in many medicines) will not be banned also in Italy, there is nothing to do. Pharmaceutical companies answer: excipient approved by the competent Authority.