Generic
Alfacalcidol
3 brands available in the market
At a glance
Active Vitamin D3 analogue indicated for the management of hypocalcemia, secondary hyperparathyroidism, and osteodystrophy in chronic renal failure.
Description
Alfacalcidol is a synthetic analogue of Vitamin D3 that rapidly converts in the liver to 1,25-dihydroxyvitamin D3 (Calcitriol), promoting intestinal calcium absorption and bone mineralization.
Indications
Indicated in adult patients with chronic renal failure for the management of hypocalcemia, secondary hyperparathyroidism, and renal osteodystrophy.
Therapeutic class
Vitamin in bone formation, Vitamin-D preparations
Pharmacological class
Vitamin D3 Analogue
Pharmacology
Alfacalcidol stimulates intestinal calcium and phosphorus absorption, bone calcium reabsorption, and renal calcium conservation. It reduces elevated plasma PTH levels and relieves bone pain in chronic kidney disease.
Mechanism of action
Undergoes 25-hydroxylation in the liver to active Calcitriol, which binds to vitamin D receptors to regulate calcium and phosphate homeostasis.
Dosage
Initial Dose: 0.25 mcg/day for first 2 months. Can be titrated by 0.25 mcg/day every 2 months. Maintenance Dose: 0.5 mcg to 1 mcg/day. Reduce dose by 50% if hypercalcemia develops.
Administration
Oral administration. Take daily as prescribed by physician.
Missed dose
Take as soon as remembered unless it is almost time for the next scheduled dose.
Side effects
Hypercalcemia, elevated BUN, dry mouth, metallic taste, nausea, vomiting, constipation, headache, anorexia, pruritus, bone pain, and hypertension.
Precautions & warnings
Regular monthly monitoring of serum calcium and phosphate levels is required. Caution in patients with history of renal calculi.
Contraindications
Contraindicated in patients with hypercalcemia, hyperphosphatemia, evidence of vitamin D toxicity, or hypersensitivity to the drug.
Drug interactions
Thiazides increase hypercalcemia risk. Antiepileptics (carbamazepine, phenytoin) increase vitamin D requirements. Corticosteroids reduce efficacy.
Food interactions
High calcium diets should be monitored to prevent hypercalcemia.
Use in pregnancy
Avoid during pregnancy unless clearly needed. Hypercalcemia during pregnancy can cause congenital disorders.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Excreted in human milk. Breastfeeding during treatment should be avoided.
Pediatric use
Safety and efficacy in pediatric patients have not been established.
Geriatric use
Use with caution and monitor serum calcium levels in elderly patients.
Renal / hepatic impairment
Indicated for renal failure; requires strict monitoring of serum calcium and phosphate levels.
Overdose effects
Discontinue drug and all calcium supplements immediately upon signs of hypercalcemia. Rehydrate patient as needed.
Storage conditions
Store below 30°C, away from light and moisture. Keep out of reach of children.
Chemical structure
Alfacalcidol (C27H44O2)