Clinical Pharmacology Details


Alfacalcidol


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Indications & Dose:

Patients with severe renal impairment requiring vitamin D therapy 



Adult: Initially 1 microgram daily, dose to be adjusted to avoid hypercalcaemia; maintenance 0.25–1 microgram daily


Elderly: Initially 500 nanograms daily, dose adjusted to avoid hypercalcaemia; maintenance 0.25–1 microgram daily


Hypophosphataemic rickets | Persistent hypocalcaemia due to hypoparathyroidism or pseudohypoparathyroidism



Child 1 month–11 years: 25–50 nanograms/kg once daily, dose to be adjusted as necessary; maximum 1 microgram per day


Child 12–17 years: 1 microgram once daily, dose to be adjusted as necessary


Prevention of vitamin D deficiency in renal or cholestatic liver disease



Child 1 month–11 years (body-weight up to 20 kg): 15–30 nanograms/kg once daily (max. per dose 500 nanograms) Child 1 month–11 years (body-weight 20 kg and above): 250–500 nanograms once daily, dose to be adjusted as necessary


Child 12–17 years: 250–500 nanograms once daily, dose to be adjusted as necessary 

Contraindications:

Hyperphosphataemia (except when occurring with hypoparathyroidism),hypercalcaemia, vitamin D toxicity


 

Side Effects:

 Hypercalcaemia and hyperphosphataemia. 

Cautions:

Precautions:

Hypercalciuria, renal impairment.
Pregnancy, breast-feeding & old age: Use with caution.

Interaction:

Drugs
Digitalis Preparations: Cardiac arrhythmias precipitated.


Thiazide Diuretics: Hypercalcaemic response enhanced.


Barbiturates and other enzyme inducing anticonvulsants: Reduce efficacy.


Mineral oil: Prolonged use reduces efficacy.


Cholestyramine, Cholestipol, Sucralfate, Aluminium based Antaicds: Reduce efficacy – by decreasing absorption of alfacalcidol.


Magnesium based Antaicds or Laxatives: Hypermagnesaemia in those on chronic  renal dialysis. 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: