Drug Index

Calcitriol

 
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Synonyms :

1, 25-dihydroxycholecalciferol

Mechanism :

It is a vitamin D derivative. It is also known as 1-25 DIHYDROXYCHOLECALCIFEROL
Natural supply of vitamin D depends mainly on exposure to the ultraviolet rays of the sun for conversion of 7-dehydrocholesterol in the skin to vitamin D3 (cholecalciferol). Vitamin D3 is then activated in the liver and the kidney before it is fully active at target tissues.


Indication :

• Vitamin D dependent rickets

• Hypophosphatemic rickets

• Hypoparathyroidism/Pseudohypoparathyroidism

• Familial Hypophosphatemia

• Hypocalcemia in premature infants

• Renal osteodystrophy

• Dialysis associated Hypocalcemia

• Secondary hyperparathyroidism in moderate to severe kidney disease


Contraindications :

Should not be given to patients with hypercalcemia or evidence of vitamin D toxicity. Also avoid in patients with hypersensitivity to calcitriol, and use with caution along with other food supplements etc.


Dosing :

0.25 mcg or 0.50 mcg capsules.

Hypocalcemia secondary to hypoparathyroidism:

Oral: 1 mcg once daily for the first 5 days of life.

Hypocalcemic tetany:

IV: 0.05 mcg/kg once daily for 5 to 12 days.

Oral: Initial: 0.25 mcg/dose once daily, followed by 0.01 to 0.15 mcg/kg/day divided in 2 doses. Maximum daily dose: 2 mcg).

Secondary hyperparathyroidism in patients with chronic kidney disease (CKD)

CKD Stages 2 to 4: Oral

<3 years: 0.01 to 0.15 mcg/kg/day PO daily (evaluate dosage at 2- to 4-week intervals).

3 years and above: 0.25-0.5 mcg PO daily (evaluate dosage at 2- to 4-week intervals).

Renal failure on dialysis:

1 to 5 years: 0.25 to 2 mcg once daily (evaluate dosage at 2- to 4-week intervals).

≥6 years: 0.25 to 1 mcg once daily.

Hypoparathyroidism/pseudohypoparathyroidism: Oral

Infants: 0.04 to 0.08 mcg/kg once daily.

1 to 5 years: 0.25 to 0.75 mcg once daily (evaluate dosage at 2- to 4-week intervals).

≥6 years: 0.5 to 2 mcg once daily.

Vitamin D dependent rickets: Oral

One mcg PO OD.

Familial Hypophosphatemia:

0.015 to 0.02 mcg/kg/day PO daily. Max: 2 mcg/day.


Adverse Effect :

Hypercalcemia syndrome: Weakness, headache, somnolence, nausea, vomiting, dry mouth, constipation, muscle pain, bone pain, abdominal pain, polyuria, polydipsia, anorexia, weight loss, nocturia, conjunctivitis (calcific), pancreatitis, photophobia, rhinorrhea, pruritus, hyperthermia, decreased libido, elevated BUN, albuminuria, hypercholesterolemia, elevated AST/ALT, ectopic calcification, nephrocalcinosis, hypertension, cardiac arrhythmias.


Interaction :

Agents which cause rise in Serum Calcium: Use with caution.
Calcium Channel Blockers: May antagonise the effects of calcium channel blockers by increasing the serum calcium levels.
Digoxin: May be associated with digoxin toxicity by increasing calcium levels.
Corticosteroids: Decrease absorption counteracting the calcitriol function of increasing calcium absorption.


07/18/2019 09:20:48 Calcitriol
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