Alfacalcidol

Indications
 Oral
Hypocalcaemia, Rickets or osteomalacia, Hypophosphataemia, Hypoparathyroidism, Renal osteodystrophy
Adult: Initially, 1 mcg daily. Maintenance: 0.25-1 mcg daily.
Child: Premature infants and neonates: 0.05-0.1 mcg/kg daily; <20 kg: 0.05 mcg/kg daily.
Elderly: 0.5 mcg daily.
Contraindications
 Hypercalcaemia, metastatic calcification, hyperphosphataemia (except when occurring with hypoparathyroidism), hypermagnesaemia.
Warnings / Precautions
 Pregnancy, lactation, renal impairment, infants, elderly. Monitor serum levels of calcium in patients with renal failure. Caution in hypercalciuria esp in those with history of renal calculi. Avoid in patients with hypersensitivity to inj. containing propylene glycol.
Adverse Reactions
 Anorexia, nausea, vomiting, diarrhoea, lassitude, polyuria, sweating, headache, thirst, vertigo, pruritus, rash, urticaria. Hypercalcaemia, hypercalciuria and ectopic calcification. In case of renal impairment, hyperphosphataemia. In hypercalcaemic dialysis patients, possibility of calcium influx from the dialysate should be considered.
Overdose Reactions
 Symptoms may include anorexia, lassitude, nausea and vomiting, constipation or diarrhoea, polyuria, nocturia, sweating, headache, thirst, somnolence and vertigo and hypercalcaemia. Management: Stop admin of alfacalcidol. Treatment is symptomatic and supportive. Ensure patient is well hydrated by i.v. infusion of saline (force diuresis). Monitor electrolytes, calcium levels, renal function, ECG (especially in patients on digitalis). Consider treatment with glucocorticosteroids, loop diuretics, bisphosphonates, calcitonin and haemodialysis with low calcium content.
Drug Interactions
 Thiazides may increase the risk of hypercalcaemia. Some antiepileptics e.g. carbamazepine, phenobarbital, phenytoin and primidone may increase vitamin D requirements. Rifampicin, isoniazid and corticosteroids may reduce the efficacy of vitamin D.
See Below for More alfacalcidol Drug Interactions
Mechanism of Actions
 Alfacalcidol is a precursor of the active calcitriol. It does not require renal hydroxylation but requires 25-hydroxylation in the liver for conversion to calcitriol.
Absorption: Adequately absorbed from the GI tract (oral).
Distribution: Adipose and muscle tissue; enters breast milk. Protein-binding: Specific to α-globulin.
Metabolism: Hepatic; rapidly converted to calcitriol.
Excretion: Faeces and urine (small amounts).
Administration
 Should be taken with food.
Storage Conditions
 Oral: Capsule: Store below 25°C. Liquid: Refrigerate at 2-8°C.
ATC Classification
 A11CC03 - alfacalcidol ; Belongs to the class of vitamin D and analogues. Used as dietary supplements.
Storage
 Oral: Capsule: Store below 25°C. Liquid: Refrigerate at 2-8°C.
Available As
  • Alfacalcidol 0.01 mcg
  • Alfacalcidol 0.010 mcg
  • Alfacalcidol 0.2 mcg
  • Alfacalcidol 0.25 mcg
  • Alfacalcidol 0.25 mg
  • Alfacalcidol 0.5 mcg
  • Alfacalcidol 1 mcg
  • Alfacalcidol 25 mcg
  • Alfacalcidol 250 mcg

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