Drug Index


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.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function. Titrate to response
10-20Dose as in normal renal function. Titrate to response
<10Dose as in normal renal function. Titrate to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
05/30/2020 01:26:09 Calcitriol
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