Calcitriol (Vit D)

Indications
Oral
Hyperparathyroidism in renal failure
Adult: 0.25 mcg daily or every other day. May increase by 0.25 mcg daily at intervals of 4-8 wk.
Child: 0.25-2 mcg daily with haemodialysis.
Oral
Hypoparathyroidism/pseudohypoparathyroidism
Adult: 0.5-2 mcg once daily.
Child: 1-5 yr: 0.25-0.75 mcg once daily; >6 yr: 0.5-2 mcg once daily.
Oral
Vitamin D-resistant rickets (familial hypophosphataemia)
Adult: 0.015-0.02 mcg/kg once daily. Maintenance: 0.03-0.06 mcg/kg once daily. Max: 2 mcg once daily.
Child: 0.015-0.02 mcg/kg once daily. Maintenance: 0.03-0.06 mcg/kg once daily. Max: 2 mcg once daily.
Oral
Hypocalcaemia in premature infants
Child: 1 mg once daily for 5 days.
Intravenous
Hyperparathyroidism in dialysis patients
Adult: 0.5-4 mcg 3 times/wk, increased if needed in steps of 0.25-0.5 mcg at intervals of 2-4 wk; max. 8 mcg 3 times/wk.
Child: 1 mcg once daily.
Intravenous
Hyperparathyroidism in renal failure
Adult: 0.5 mcg daily 3 times/wk if undergoing haemodialysis. If necessary, dose can be increased by 0.25-0.5 mcg at intervals of 2-4 wk. Maintenance: 0.5-3 mcg 3 times/wk.
Intravenous
Hypocalcaemic tetany in premature infants
Child: 0.05 mcg/kg once daily for 5-12 days.
Contraindications
Hypercalcaemia; evidence of vitamin D toxicity. Pregnancy (dose exceeding RDA). Lactation.
Warnings / Precautions
Idiopathic hypercalcaemia. Pediatric doses must be individualised and monitored under close medical supervision. Coronary disease, renal function impairment and arteriosclerosis, especially in the elderly. Hypoparathyroidism.
Adverse Reactions
Weakness; headache; somnolence; nausea; vomiting; dry mouth; constipation; muscle pain; bone pain; metallic taste; polyuria; polydipsia; anorexia; irritability; weight loss; nocturia; mild acidosis; reversible azotemia; generalized vascular calcification; nephrocalcinosis; conjunctivitis (calcific); pancreatitis; photophobia; rhinorrhoea; pruritus; hyperthermia; decreased libido; elevated BUN; albuminuria; hypercholesterolaemia; elevated AST and ALT; ectopic calcification; hypertension; cardiac arrhythmias.
Overdose Reactions
Symptoms include hypercalcemia, hypercalciuria and hyperphosphatemia. Treatment: Immediate discontinuation of calcitriol therapy, institute low-calcium diet and withdraw calcium supplements. Determine serum calcium levels daily until normocalcaemia returns.
Drug Interactions
Hypermagnesaemia may develop in patients on chronic renal dialysis. Hypercalcaemia in patients on digitalis may precipitate cardiac arrhythmias. Intestinal absorption of calcitriol may be reduced by cholestyramine and colestipol. Phenytoin, barbiturates may decrease the T1/2 of calcitriol. May develop hypercalcaemia with thiazide diuretics.
See Below for More calcitriol Drug Interactions
Mechanism of Actions
Calcitriol promotes calcium absorption in the intestines and retention at the kidneys thus increasing serum calcium levels. It also increases renal tubule phosphate resorption consequently decreasing serum phosphatase levels, PTH levels and bone resorption.
Absorption: Well absorbed from the GI tract.
Excretion: Mainly excreted in the bile and faeces.
Administration
May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
Storage Conditions
Intravenous: Store at 15-30°C. Oral: Store at 15-30°C.
ATC Classification
D05AX03 - calcitriol ; Belongs to the class of other antipsoriatics for topical use.
A11CC04 - calcitriol ; Belongs to the class of vitamin D and analogues. Used as dietary supplements.
Storage
Intravenous: Store at 15-30°C. Oral: Store at 15-30°C.
Available As
  • Calcitriol (Vit D) 0.05 mcg
  • Calcitriol (Vit D) 0.0625 mcg
  • Calcitriol (Vit D) 0.0625 mg
  • Calcitriol (Vit D) 0.1 mcg
  • Calcitriol (Vit D) 0.2 mcg
  • Calcitriol (Vit D) 0.25 gm
  • Calcitriol (Vit D) 0.25 mcg
  • Calcitriol (Vit D) 0.25 mg
  • Calcitriol (Vit D) 0.75 mcg
  • Calcitriol (Vit D) 1 mcg
  • Calcitriol (Vit D) 25 mcg
  • Calcitriol (Vit D) 3 mcg
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