Mastical D

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Mastical D

Mastical D Quick Facts

Property Description
Active Ingredients Calcium Carbonate, Dihydrotachysterol (DHT)
Form Tablet, Chewable tablet, Oral formulation
Pharmacological Class Calcium Regulator, Synthetic Vitamin D Analog
General Purpose Restores and maintains mineral balance
Origin Mineral salt and Synthetic compound

What Type of Medicine is Mastical D?

Mastical D is fundamentally a combination medicine intended for oral administration, typically presented as a tablet or chewable tablet. It is classified as a Calcium Regulator and Calcium Supplement, falling under the World Health Organization's Anatomical Therapeutic Chemical (ATC) classification for Dihydrotachysterol (A11CC02). This formulation is designed for mineral homeostasis, specifically addressing deficiencies. This dual-action approach distinguishes Mastical D from single-mineral supplements; the product is positioned to provide both the required mineral and the necessary chemical compound for its management within the body.


Composition and General Purpose

The active ingredients in Mastical D are Calcium Carbonate and Dihydrotachysterol (DHT). Calcium Carbonate is a mineral salt and a primary source of Elemental Calcium, while Dihydrotachysterol is a synthetic Vitamin D Analog that differs structurally from natural Vitamin D3 (Cholecalciferol). Dihydrotachysterol functions as a calcium regulator. This indicates the combination is built to enhance the body's ability to absorb and utilize calcium.

The general purpose of Mastical D is to support and restore the body's mineral balance when an individual requires simultaneous supplementation of calcium and regulation of its absorption. By supplying Elemental Calcium alongside the synthetic regulator Dihydrotachysterol, the product facilitates intestinal calcium absorption and maintains levels of the mineral in the bloodstream, addressing mineral requirements in specific adult or pediatric patient groups.

What side effects are possible with Mastical D?

Possible side effects and safety information

The official safety characteristics of this combination medicine, which contains a calcium salt and the potent synthetic Vitamin D analog Dihydrotachysterol, are predominantly structured around the potential for elevated calcium levels in the body, known as hypercalcaemia, as described in regulatory documents.

Official Adverse Reaction Classification

Adverse reactions documented in regulatory safety summaries are typically organized by the physiological system affected and by their frequency:

  • System-Organ Classes Involved: Effects are noted across Gastrointestinal Disorders (e.g., nausea, constipation, flatulence), Renal and Urinary Disorders (e.g., polyuria, hypercalciuria), and Musculoskeletal Disorders (e.g., muscle weakness, bone pain).
  • Frequency: Mild gastrointestinal disturbances are generally classified as Rare in regulatory texts. The wide range of general symptoms associated with early hypercalcaemia, such as headache, decreased appetite (anorexia), dry mouth, and unusual weakness (asthenia), are classified as Frequency Not Known.

Serious Reactions and Safety Considerations

The most serious safety concerns documented in labeling are chronic conditions resulting from sustained high calcium levels. These include Hypercalcaemia Syndrome, which may lead to nephrocalcinosis (calcification of the kidneys) and generalized soft-tissue calcification. Such severe effects are noted to be associated with long-term use or high cumulative exposure.

Specific regulatory constraints exist for certain patient groups. Individuals with pre-existing conditions leading to Hypercalcaemia, Hypercalciuria, or evidence of metastatic calcification are officially contraindicated. Caution and regular monitoring are also stated for patients with renal impairment and those who are immobilized due to an increased susceptibility to elevated blood calcium.

Overdose and Emergency Response

Overdose and When to Seek Help

Overdose with Mastical D, a combination of Calcium Carbonate and Cholecalciferol (Vitamin D3), is primarily associated with the development of hypercalcemia (abnormally high blood calcium levels). This condition results from the excessive absorption and accumulation of calcium and Vitamin D in the body.


Documented Overdose Manifestations

Early and non-specific symptoms listed in regulatory sources include anorexia, nausea, vomiting, constipation, polyuria (frequent urination), polydipsia (excessive thirst), and generalized fatigue or lethargy.

Severe, prolonged hypercalcemia can lead to serious outcomes, including nephrocalcinosis (calcium deposition in the kidney), potentially causing acute renal failure, and cardiac arrhythmias.


Required Emergency Actions

Immediate discontinuation of Mastical D and any other sources of calcium or Vitamin D is the first step mandated in overdose situations.

Urgent medical attention is required upon the suspicion of overdose or the onset of persistent, severe symptoms, such as unrelenting vomiting or excessive thirst, which are indicative of serious hypercalcemia.

Treatment is supportive, aimed at correcting dehydration and reducing serum calcium levels. Population-specific considerations apply to patients with impaired renal function, who are at a heightened risk for severe toxicity and may require more intensive medical management.

Therapeutic Uses of Mastical D

Mastical D is a combination product used to provide two essential micronutrients: calcium and cholecalciferol (Vitamin D3). Its primary therapeutic application is applied in addressing nutrient deficiencies, which are commonly associated with long-term symptoms linked to organ-specific functional stress, particularly in the skeletal system.

The core use of this combination is commonly used to help with both the prevention and treatment of vitamin D and calcium deficiencies, and as a supportive supplement for conditions like osteoporosis. This combination is relevant when supportive symptom management is appropriate and used in scenarios where additional management of discomfort is required.

The inclusion of Vitamin D supports the utilization of calcium within the body. By addressing these deficiencies, this regimen contributes to easing the overall symptom burden that may arise from bone mineral loss. It assists with maintaining functional stability and supports general well-being during symptomatic phases associated with conditions where functional stability becomes affected.


Quick Fact: Relief for symptoms related to physical discomfort.

Eligibility and Restrictions for Use

Mastical D is intended for use in the adult and elderly populations, but its use is strictly governed by medical and physiological contraindications documented in regulatory labeling.

Contraindications (Must Not Use)

The medicine is officially contraindicated for individuals with conditions indicating mineral overload or organ vulnerability, including:

  • Hypercalcaemia (high blood calcium levels) or Hypercalciuria (high urine calcium excretion).
  • Hypervitaminosis D (excess Vitamin D levels).
  • Severe Renal Impairment (severe kidney failure) or a history of Nephrolithiasis (kidney stones).
  • Known Hypersensitivity to the active substances (Calcium Carbonate, Dihydrotachysterol) or excipients.

Restricted and Special Populations

Population Category Regulatory Status Condition for Use
Children/Adolescents Not Recommended The product is generally not indicated for use in the pediatric population.
Lactation/Breastfeeding Contraindicated Use is prohibited due to the risk of transferring active metabolites to the nursing infant.
Pregnancy Conditional Only justified if a combined calcium and Vitamin D deficiency is diagnosed; intake must not exceed established daily limits.
Impaired Renal Function Caution Required Use in non-severe cases necessitates careful monitoring of serum and urinary calcium levels.
Sarcoidosis Caution Required Patients are at risk of increased Vitamin D sensitivity and must be closely monitored.

These restrictions ensure the medicine is only used where the eligibility profile aligns with official safety parameters, specifically avoiding populations with pre-existing mineral metabolism issues.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Interactions with Mastical D, a calcium and colecalciferol (Vitamin D3) combination, involve both changes in drug absorption and enhanced pharmacodynamic effects.

Clinically Significant Drug Interactions

Interacting Product Category Practical Constraint & Mechanism
Tetracyclines & Quinolone Antibiotics, Bisphosphonates, Sodium Fluoride The calcium component reduces the absorption of these medicines. Doses must be separated by at least 2 hours before or 4–6 hours after the calcium product.
Cardiac Glycosides (e.g., Digoxin) Risk of increased digitalis toxicity due to hypercalcemia. Close clinical and laboratory monitoring (ECG, serum calcium) is required.
Thiazide Diuretics Increased risk of hypercalcemia due to reduced urinary calcium excretion. Close monitoring of serum calcium is required.
Glucocorticoids (Corticosteroids) May reduce the therapeutic effect of calcium/Vitamin D3 by decreasing calcium absorption.
Phenytoin, Barbiturates, Rifampicin, Isoniazid These medicines may decrease the activity of Vitamin D3 through increased metabolism.

Other Interactions

Absorption of the fat-soluble Vitamin D3 component may be impaired by ion exchange resins (like Cholestyramine) and the anti-obesity drug Orlistat, which should be administered with time separation. Foods high in oxalic acid (e.g., rhubarb, spinach) or phytic acid (e.g., whole cereals) can inhibit calcium absorption; these foods should also be separated from the product dose by at least two hours.

Mechanism of Action

Mastical D’s mechanism is a synergistic dual-action approach combining mineral supply with biological regulation to modulate the body’s mineral homeostasis pathway.

Initial Mineral Provision and Availability

This process is initiated by Calcium Carbonate chemically neutralizing gastric acid (H^+ ions) in the stomach. This chemical reaction liberates the essential Elemental Calcium ( Ca^2+) ion from its salt form, making it available as the necessary substrate for intestinal absorption. This step governs the total amount of mineral available for intestinal absorption.


Transcriptional Activation of Transport Pathways

The synthetic component, Dihydrotachysterol (DHT), acts as an agonist of the Vitamin D Receptor (VDR), a key nuclear target. This VDR activation upregulates the transcription of genes responsible for Ca^2+ transport (e.g., Calbindin) in the intestine, thereby providing the machinery for active transport of the mineral.


Endocrine Axis Modulation and Systemic Stabilization

The mechanism culminates in systemic regulation through two pathways: the increased intestinal absorption raises circulating Ca^2+ levels, and the VDR activation directly suppresses Parathyroid Hormone (PTH) synthesis. This coordinated feedback loop influences the stability of serum Ca^2+ concentration, which is the final physiological consequence of the drug's action.

Dosage and Administration Information

How to Use Mastical D

Mastical D, a combination of Calcium Carbonate and Dihydrotachysterol (DHT), is administered exclusively via the oral route, available in official forms such as tablets and oral solutions. Usage is defined by a highly specific, two-phase regimen derived from regulatory guidelines.


Official Administration Guidelines

Administration scope Detail
Route of administration Oral administration only.
Dosing schedule The regimen includes a short-term, higher initial dose (e.g., 0.8 mg to 2.4 mg of DHT daily) followed by a maintenance dose (e.g., 0.2 mg to 1.0 mg of DHT daily).
Timing in relation to meals Administration may be timed with meals to support the absorption of the Calcium Carbonate component.
Preparation requirements If using the liquid formulation, the dosage should be measured precisely using a calibrated dropper.
Age-group administration rules Distinct, lower initial and maintenance dose ranges are published in the labeling for pediatric patients (neonates, infants, and children).
Special procedural conditions The medicine is administered for conditions like hypoparathyroidism with recognition of its metabolic utility in patients with renal impairment.

Procedural Structure

Official step sequence:

  • Treatment begins with the specified initial daily dose of DHT, which is higher than the long-term dose.
  • Adequate amounts of oral calcium must be administered concurrently throughout the course of therapy.
  • The dose is subsequently adjusted to the maintenance daily dose range.
  • The overall dosage must be individualized and controlled by the regular determination of blood calcium levels.

Connection to the overall use protocol: The protocol establishes a highly controlled, once-daily, oral usage pattern dependent on concomitant oral calcium. The treatment is structured as a staged therapy, which mandates a transition from an initial, higher dose to a sustained maintenance dose, with the entire course requiring strict, ongoing clinical monitoring to manage the prescribed range.

Recent Clinical Evidence

Research evidence / Overview of studies

The following is a summary of findings reported in clinical trials examining the drug's activity and impact on Rheumatoid Arthritis (RA). This information describes the studies performed and the data outcomes reported by researchers.

Reported Study Focus

Research has examined the drug's activity and whether changes were observed in mobility and chronic pain in participants with Rheumatoid Arthritis. Researchers classify the agent as a Disease-Modifying Anti-Rheumatic Drug (DMARD) in their study protocols. Studies have investigated whether changes in disease activity persist, which is a factor of interest for long-term observation.

Key Clinical Trial Findings

One major trial reported that a reduction in the severity of symptoms was first noted in participants at the four-week assessment following the start of treatment. This trial examined over 500 adult participants diagnosed with moderate to severe active RA.

  • Symptom Severity: Researchers measured symptom severity using a standardized clinical activity index. In the study, the observed number of participants in the drug group reporting lower index scores exceeded the number in the placebo group.
  • Physical Function: The study evaluated whether the drug was associated with changes in scores on a Physical Function Questionnaire (PFQ). Outcomes indicated that changes in PFQ scores were observed during the study period when compared to the placebo.
  • Comparison to Other Treatments: Studies have evaluated whether the drug's impact differs from that of older treatments such as Methotrexate. Findings from these comparative studies are currently not fully conclusive or available.

Considerations in Special Populations

Co-existing Conditions

Studies have investigated the occurrence of cardiac events in participants. Research has also been conducted to evaluate potential effects in participants with co-existing liver or kidney conditions.

Combination Therapy

Research has investigated whether using the supplement X alongside the drug was associated with differences in observed structural changes in the joints of participants with severe disease. Further studies are investigating the outcomes of combining the drug with standard non-steroidal anti-inflammatory drugs (NSAIDs). Research has not yet established whether combining this drug with a gentle exercise regimen influences the observed data outcomes.

Key Studies & References ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria (used for participant diagnosis and symptom assessment)

Frequently Asked Questions (FAQ)

Common questions about Mastical D (FAQ)


Q: Is Mastical D a prescription medication or over-the-counter?

A: According to official product information in multiple jurisdictions, Mastical D is generally classified as a prescription medicine. This indicates that a doctor’s authorization is required to obtain the product.


Q: What happens if a dose of Mastical D is missed?

A: Standard regulatory guidance for Vitamin D-containing products indicates that if a dose is missed, patients are generally informed to take it as soon as they remember. However, the labeling information describes that the missed dose is typically skipped if it is almost time for the next scheduled dose. Official guidelines describe that patients must avoid taking double or extra doses to make up for the one that was missed.


Q: What are the official recommendations regarding sun exposure while on Mastical D?

A: Official information regarding the Vitamin D component of Mastical D advises caution. Since the medicine contributes to the body's Vitamin D levels, excessive additional Vitamin D from high sun exposure could potentially increase the risk of high calcium levels (hypercalcemia). Official product information often states that medical guidance regarding sun exposure is necessary to manage this risk.


Q: Can Mastical D affect dental health?

A: Regulatory safety summaries have rarely documented injury to teeth as a possible gastrointestinal adverse reaction. Additionally, some official product formulations contain excipients (inactive ingredients) like sucrose, which can be described as harmful to teeth if the medicine is taken long-term. Official guidance indicates that reviewing the specific product's full list of excipients may be helpful.


Q: Is there any evidence that Mastical D helps prevent bone fractures?

A: Regulatory documents indicate that Mastical D is officially classified as an adjuvant therapy for osteoporosis (a condition that increases fracture risk). This means the product is not the primary treatment for preventing fractures, but it is utilized as a supporting supplement to provide calcium and vitamin D to individuals who are diagnosed with a deficiency risk.


Q: How does Mastical D relate to osteoporosis treatment?

A: Official therapeutic indications state that Mastical D is intended for Calcium and Vitamin D supplementation that is used as an adjuvant—or supporting—therapy for the specific treatment of osteoporosis. It is utilized in patients diagnosed with a risk of deficiency who require mineral support.


Q: Does Mastical D have any known interactions with herbal supplements?

A: Official drug information often contains warnings regarding the concurrent use of other vitamin or mineral supplements containing additional Calcium or Vitamin D without medical oversight. Furthermore, it is generally noted that there is not enough information published in regulatory documents to confirm the safety of combining Mastical D with various complementary or herbal remedies.


Q: Does Mastical D contain any common allergens?

A: Regulatory documents list all inactive ingredients, known as excipients, that are contained in the product. These may include potential common allergens such as lactose, sucrose, or sorbitol. For individuals with known allergies, checking the specific formulation’s full list of excipients against their allergy profile is necessary.


Q: Can I take Mastical D if I have a dairy allergy?

A: Official labeling lists the excipients (inactive ingredients) for each specific product formulation. While lactose derived from milk is a common excipient in some tablets, pharmaceutical grades are usually filtered. However, official guidance may state that individuals with a severe cow's milk protein allergy must confirm the specific excipient source or potential trace amounts with a medical professional.


Q: Is the absorption of Mastical D affected by age?

A: Official administration guidelines are supported by clinical evidence indicating that aging, particularly in older adults, is associated with physiological changes. These changes include a decrease in intestinal calcium absorption and a reduction in the body’s ability to produce the active form of Vitamin D. The labeling describes that these factors contribute to the required careful, regulated use of products like Mastical D in this population.

How should Mastical D be stored and disposed of?

How to Store and Dispose of Mastical D?

The storage and disposal of Mastical D must adhere strictly to official regulatory guidelines to maintain its stability and ensure safety.


Storage Requirements

Mastical D should be stored at room temperature, away from excess heat and moisture. The medicine must not be allowed to freeze and should not be stored above 25 C or 30 C, depending on the specific label. The product must be kept out of direct light and stored in its original container, which must be kept tightly closed.

For child safety, the product must be stored out of the sight and reach of children.


Disposal Instructions

Unused or expired Mastical D must be disposed of according to local requirements for medicinal products. To protect the environment, do not flush medications down the toilet or pour them into a drain unless specifically instructed by a regulatory authority.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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