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KAL'CIJ-D3 NIKOMED KOMFORTE

KAL'CIJ-D3 NIKOMED KOMFORTE

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Andreea Mateescu

Pediatrics8 years of experience

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use KAL'CIJ-D3 NIKOMED KOMFORTE

INSTRUCTIONS for medical use of the medicinal product KYURLED

KYURLED is used in combination with other medicinal products for the treatment of chronic hepatitis C (CHC) in adult patients.

Composition

Active substance: sofosbuvir; 1 film-coated tablet contains 400 mg of sofosbuvir; excipients: mannitol 60 (E 421), microcrystalline cellulose, sodium croscarmellose, colloidal silicon dioxide, magnesium stearate; tablet coating: Opadry II Blue (85F505068).

Pharmaceutical form

Film-coated tablets.

Main physical and chemical properties

Blue, capsule-shaped, biconvex film-coated tablets with engraving "400" on one side and smooth on the other.

Pharmacotherapeutic group

Antiviral agents for systemic use. Direct-acting antiviral agents. Antiviral agents for the treatment of hepatitis C virus (HCV).

ATC code

J05A P08.

Pharmacological properties

Pharmacodynamics
Mechanism of action

Sofosbuvir is a pan-genotypic inhibitor of the HCV NS5B RNA polymerase, which is essential for the replication of the virus. Sofosbuvir is a nucleotide prodrug that, after intracellular metabolism, forms the pharmacologically active uridine analog triphosphate (GS-461203), which can be incorporated into the HCV RNA by the NS5B polymerase and acts as a chain terminator.

Antiviral activity

In HCV replicon analyses, the effective concentrations (EC50) of sofosbuvir against full-length replicons of genotypes 1a, 1b, 2a, 3a, and 4a were 0.04, 0.11, 0.05, 0.05, and 0.04 μM, respectively, and the EC50 values of sofosbuvir against chimeric replicons of 1b, which encode NS5B from genotypes 2b, 5a, or 6a, were between 0.014 and 0.015 μM.

Resistance

Cell culture. HCV replicons with reduced susceptibility to sofosbuvir were selected in cell culture for multiple genotypes, including 1b, 2a, 2b, 3a, 4a, 5a, and 6a.

Pharmacokinetics

Sofosbuvir is a nucleotide prodrug that undergoes extensive metabolism. The active metabolite is formed in hepatocytes and is not detected in plasma.

Absorption

The pharmacokinetic properties of sofosbuvir and its main circulating metabolite GS-331007 were evaluated in healthy adult subjects and patients with chronic hepatitis C.

Distribution

Sofosbuvir is not a substrate for the uptake transporters OATP1B1 or OATP1B3, or the efflux transporters P-glycoprotein or BCRP.

Metabolism

Sofosbuvir is extensively metabolized in the liver to form the pharmacologically active nucleoside analog triphosphate GS-461203.

Elimination

Following a single oral dose of 400 mg [14C]-sofosbuvir, the mean total recovery of the dose was greater than 92%, consisting of approximately 80%, 14%, and 2.5% recovered in urine, feces, and expired air, respectively.

Clinical characteristics

Indications

KYURLED is used in combination with other medicinal products for the treatment of chronic hepatitis C (CHC) in adult patients.

Contraindications

Hypersensitivity to the active substances or to any of the excipients of the medicinal product.

Special warnings and precautions for use

Special precautions. KYURLED should not be used as monotherapy and should be used in combination with other medicinal products for the treatment of hepatitis C virus infection.

Severe bradycardia and heart block

When KYURLED is used in combination with other direct-acting antiviral agents (DAAs) (including daclatasvir, simeprevir, and ledipasvir) and concomitantly with amiodarone, cases of severe bradycardia and heart block have been reported.

Patient with HCV genotype 1, 4, 5, or 6 infection who have previously failed treatment

The efficacy of KYURLED in patients with HCV genotype 1, 4, 5, or 6 infection who have previously failed treatment has not been studied.

Patient with HCV genotype 5 or 6 infection who have previously failed treatment

Data on the use of KYURLED in patients with HCV genotype 5 or 6 infection who have previously failed treatment are very limited.

Concomitant use with other direct-acting antiviral agents against HCV

KYURLED can be used in combination with other direct-acting antiviral agents, only if the available data indicate that their efficacy outweighs the risks.

Pregnancy and concomitant use with ribavirin

When KYURLED is used in combination with ribavirin or peginterferon alfa-2/ribavirin, women of childbearing potential or their male partners should use effective contraception during treatment and for a period after treatment.

Use with moderate P-glycoprotein inducers

Medicinal products that are moderate inducers of P-glycoprotein in the intestine (such as oxcarbazepine and modafinil) may decrease the plasma concentration of sofosbuvir, leading to reduced therapeutic effect of KYURLED.

Renal impairment

The safety of KYURLED has not been assessed in patients with severe renal impairment (eGFR <30 mL/min/1.73 m2) or in patients with chronic kidney disease requiring hemodialysis.

HCV/HBV co-infection (hepatitis B virus)

During or after treatment with direct-acting antiviral agents, cases of hepatitis B virus (HBV) reactivation have been reported, some of which were fatal.

Pediatric population

KYURLED is not recommended for use in children (under 18 years of age), as the safety and efficacy have not been established in this population.

Interaction with other medicinal products and other forms of interaction

Sofosbuvir is a nucleotide prodrug that undergoes extensive metabolism. After administration of KYURLED, sofosbuvir is rapidly absorbed and undergoes intensive first-pass metabolism in the liver and stomach.

Interaction table
Medicinal product by therapeutic groupEffect on the medicinal product. Mean ratio (90% confidence interval) for AUC, Cmax, Cmin.a,bRecommendations for use with KYURLED
ANALEPTICSInteraction not studied. Expected: ↓ Sofosbuvir ↔ GS-331007It is expected that concomitant use of KYURLED with modafinil will decrease the concentration of sofosbuvir, leading to reduced therapeutic effect of KYURLED. Such concomitant use is not recommended.
ANTIARRHYTHMIC AGENTSInteraction not studied.Use only when there are no alternative treatments. When used with KYURLED and another DAA (see "Special warnings and precautions for use" and "Adverse reactions"), close monitoring is recommended.
ANTICOAGULANTSInteraction not studied.When using all vitamin K antagonists, it is recommended to closely monitor INR. This is due to changes in liver function during treatment with KYURLED.

Special instructions

Women of childbearing potential/contraception for men and women

When KYURLED is used in combination with ribavirin or peginterferon alfa-2/ribavirin, special attention should be paid to preventing pregnancy in female patients and their male partners.

Use during pregnancy or breastfeeding

There are no or limited data (less than 300 pregnancy outcomes) on the use of sofosbuvir in pregnant women.

Ability to influence the speed of reaction when driving vehicles or operating other mechanisms

KYURLED has a moderate influence on the ability to drive vehicles and work with complex mechanisms.

Method of administration and dosage

Adults

Recommended dose - 400 mg in the form of a tablet, which should be taken orally once a day during meals.

Table of recommendations for concomitant use of medicinal products and duration of comprehensive therapy with KYURLED
Patient population*TherapyDuration of treatment
Patients with genotype 1, 4, 5, or 6 CHCKYURLED + ribavirin + peginterferon alfa-212 weeksa,b
KYURLED + ribavirin24 weeks
Dose adjustment

Dose reduction of KYURLED is not recommended.

Elderly patients

Dose adjustment for elderly patients is not required.

Renal impairment

No dose adjustment of KYURLED is required for patients with mild or moderate renal impairment.

Hepatic impairment

No dose adjustment of KYURLED is required for patients with mild, moderate, or severe hepatic impairment.

Overdose

The maximum reported dose of sofosbuvir is a single dose of 1200 mg, which was administered to 59 healthy subjects.

Adverse reactions

Brief overview of the safety profile. During treatment with sofosbuvir in combination with ribavirin or with peginterferon alfa-2 and ribavirin, the most common adverse reactions were those expected based on the safety profiles of sofosbuvir and peginterferon alfa-2.

Table of adverse reactions
FrequencySOFa+ RBVbSOF + PEGc+ RBV
oftenrhinopharyngitis

Shelf life

3 years.

Storage conditions

Store in the original packaging at a temperature not exceeding 30 °C.

Packaging

White high-density polyethylene bottle with an aluminum foil and a polypropylene child-resistant cap.

Release category

Prescription only.

Manufacturer

Strides Pharma Science Limited.

Manufacturer's location and address

No. 36/7, Suragajakkanahalli, Indlawadi Cross, Anekal Taluk, Bangalore, Karnataka 562106, India.

Applicant

Strides Pharma Science Limited.

Applicant's location

201, Devawrata Sector 17, Vashi, Navi Mumbai – 400 703, India.

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Online doctors for KAL'CIJ-D3 NIKOMED KOMFORTE

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for KAL'CIJ-D3 NIKOMED KOMFORTE – subject to medical assessment and local rules.

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Doctor

Andreea Mateescu

Pediatrics8 years of experience

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
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Salome Akhvlediani

Pediatrics12 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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Yevgen Yakovenko

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Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Common reasons for consultation include:

  • abdominal pain, cramps, discomfort, painful bowel movements
  • heartburn, acid reflux, burping, bitter taste in the mouth
  • bloating, excessive gas, nausea or vomiting
  • diarrhoea, constipation, difficulty passing stool
  • unexplained changes in weight or appetite
  • concern about gut health or long-term digestive issues
  • changes in lab results, questions about test interpretation
  • digestive system cancer screening and prevention
  • general digestive check-ups and health assessments
Dr Habrykevych follows evidence-based medical standards and adapts each consultation to the patient’s individual situation. The online format allows for timely medical support without the need for an in-person visit.
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  • chronic pharyngitis and recurrent tonsillitis
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  • nosebleeds, earwax build-up, or foreign bodies in the ear, nose, or throat
  • Eustachian tube dysfunction and related complaints
Dr Travkina follows evidence-based guidelines and ensures patients receive clear explanations and follow-up recommendations. Whether you need help with ENT symptoms, clarification of test results, or guidance on next steps – she offers expert medical advice in a convenient online format.
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  • depression and anxiety disorders
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  • treatment planning and medication adjustment
Dr. Laafif combines scientific expertise with human empathy, helping patients restore emotional balance, improve daily functioning, and regain confidence in their recovery journey.
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Hocine Lokchiri

General medicine21 years of experience

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Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
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Svetlana Kovalenko

Family medicine15 years of experience

Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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Muhammad Tayyab Altaf

General medicine3 years of experience

Dr. Muhammad Tayyab Altaf is a primary care physician with extensive international experience, offering online consultations for adults and children. His background includes clinical practice in Italy, the United States and other healthcare settings, allowing him to manage a wide range of acute and chronic medical conditions with confidence and clarity.

His clinical expertise spans multi-system conditions, preventive care and long-term management of chronic diseases. Dr. Altaf combines hands-on experience with a strong research background in both medical and surgical fields, enabling him to provide accurate assessments and structured, evidence-based treatment plans. Patients value his ability to explain diagnoses clearly, outline next steps and support them in making informed healthcare decisions.

Online consultations with Dr. Altaf are suitable for many everyday and acute situations where a timely medical opinion can help determine the safest next steps. He evaluates and treats conditions affecting the cardiovascular, respiratory, gastrointestinal, neurological, haematological and endocrine systems. Common examples include:

  • hypertension and other blood pressure issues
  • ischaemic heart disease and angina
  • asthma, COPD and emphysema
  • pneumonia and lung fibrosis
  • gastroenteritis and digestive infections
  • liver conditions, including alcohol-related disease
  • epilepsy, seizures and post-stroke symptoms
  • dementia and cognitive decline
  • anaemia and other haematological changes
  • diabetes, thyroid disorders and pituitary disease
Many patients reach out when they experience new or worsening symptoms, fluctuations in blood pressure, non-severe chest discomfort, breathing symptoms, digestive issues, suspected infections, chronic fatigue or concerns that affect daily life. He also helps patients understand test results, adjust existing treatment plans and navigate long-term health strategies safely and effectively.

When clinically appropriate, Dr. Altaf can also provide health and fitness certificates, including documentation required for physical activity, sports participation or gym use, based on the patient’s health status and medical indications.

Some conditions are not suitable for online care. Severe chest pain, loss of consciousness, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack require immediate attention from local emergency services. Dr. Altaf prioritises patient safety and will guide you accordingly if your situation needs urgent in-person care.

In all consultations, Dr. Muhammad Tayyab Altaf focuses on clear communication, accurate diagnosis and patient-centred decision-making. His approach ensures that individuals and families feel informed, supported and confident in their next steps, no matter where they are.

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Tomasz Grzelewski

Dermatology21 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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