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Alfacalcidol information from DrugsUpdate  

See Available Brands of Alfacalcidol in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation

Alfacalcidol (or 1-hydroxycholecalciferol) is an analogue of vitamin D. It is currently manufactured and marketed by Vitamin Derivatives Inc. as a poultry feed additive for the prevention of tibial dyschondroplasia as well as phytate phosphorus utilization.

Pharmacodynamics

Pharmacokinetics

Afacalcidol 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).

Alfacalcidol Indications / Alfacalcidol Uses

Information Not Available

Alfacalcidol Adverse Reactions / Alfacalcidol Side Effects

Anorexia, nausea, vomiting, diarrhoea, lassitude, polyuria, sweating, headache, thirst, vertigo, pruritus, rash, urticaria. Hypercalcaemia, hypercalciuria ad ectopic calcification. In case of renal impairment, hyperphosphataemia. In hypercalcaemic dialysis patients, possibility of calcium influx from the dialysate should be considered.

Precautions

Information Not Available

Special 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 injections containing propylene glycol.

Other Drug Interactions

Thiazides may increase the risk of hypercalcaemia. Some antiepileptics e.g carbamazeepine, phenobarbital, phenytoin, primidone may increase vitamin D requirments.Rifampicin, INH & corticosteroids may reduce the efficacy of Vitamin D.

Other Interactions

Information Not Available

Dosage

Oral
Hypocalcaemia, Renal osteodystrophy, Hypoparathyroidism, Rickets or osteomalacia, Hypophosphataemia. Adult- Initially, 1 mcg daily. Maintenance: 0.25-1 mcg daily. Adult- Initially, 1 mcg daily. Maintenance: 0.25-1 mcg daily.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.

Food(before/after)

Should be taken with food.

List of Contraindications

Alfacalcidol and Pregnancy

Taking too much alfacalcidol, calcifediol, calcitriol, dihydrotachysterol, or ergocalciferol can also be harmful to the fetus. Taking more than prescribed amount can cause the baby to be more sensitive than usual to its effects, can cause problems with a gland called the parathyroid, and can cause a defect in the baby's heart. Doxercalciferol or paricalcitol have not been studied in pregnant women. However, studies in animals have shown that paricalcitol causes problems in newborns.

Alfacalcidol and Lactation

Only small amounts of alfacalcidol, calcifediol, calcitriol, or dihydrotachysterol pass into breast milk and these amounts have not been reported to cause problems in nursing babies.


It is not known whether doxercalciferol or paricalcitol passes into breast milk.

Alfacalcidol and Children

Problems in children have not been reported with intake of normal daily recommended amounts. Some studies have shown that infants who are totally breast-fed, especially with dark-skinned mothers, and have little exposure to sunlight may be at risk of vitamin D deficiency. Some infants may be sensitive to even small amounts of alfacalcidol, calcifediol, calcitriol, dihydrotachysterol, or ergocalciferol. Also, children may show slowed growth when receiving large doses of alfacalcidol, calcifediol, calcitriol, dihydrotachysterol, or ergocalciferol for a long time.Studies on doxercalciferol or paricalcitol have been done only in adult patients, and there is no specific information comparing the use of doxercalciferol or paricalcitol in children with use in other age groups.

Alfacalcidol and Geriatic

Problems in older adults have not been reported with intake of normal daily recommended amounts. Studies have shown that older adults may have lower blood levels of vitamin D than younger adults, especially those who have little exposure to sunlight. Your health care professional may recommend that you take a vitamin supplement that contains vitamin D.

Alfacalcidol and Other Contraindications

Hypercalcaemia, metastatic calcification, hyperphosphataemia (except when occurring with hypoparathyroidism), hypermagnesaemia.

Storage

Oral
Capsule: Store below 25°C. Liquid: Refrigerate at 2-8°C.

Lab interference

Oral
Capsule: Store below 25°C. Liquid: Refrigerate at 2-8°C.

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