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Calcitriol (calcitriol)

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Last reviewed · Source: First Databank (FDB) drug data

Overview

Calcitriol, the 1,25-dihydroxylated form of cholecalciferol, is a vitamin D analog.

USES: Calcitriol is a man-made active form of vitamin D. Most people get enough vitamin D from exposure to the sun and from fortified food products (such as dairy products, vitamins). Vitamin D helps control parathyroid hormone and the levels of certain minerals (such as calcium, phosphorus) that are needed for building and keeping strong bones.

Before regular vitamin D can be used by the body, it needs to be changed to the active form by the liver and kidneys. Calcitriol is used in patients with kidney disease who can't make enough of the active form of Vitamin D. This medication is also used to prevent and treat certain types of calcium/phosphorus/parathyroid problems that can happen with long-term kidney dialysis or hypoparathyroidism.

Calcitriol is usually used along with specific diet recommendations and sometimes other medications.

Generic name: calcitriol
Pronunciation: (KAL-si-TRYE-ol)

Reference product & biosimilars

No reference, biosimilar or interchangeable associated with this drug.

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Indications

The following indications are listed for Calcitriol:

  • Hyperparathyroidism Secondary To Chronic Renal Failure
  • Hypocalcemia
  • Hypocalcemia From End-Stage Renal Disease With Dialysis
  • Hypoparathyroidism
  • Hypophosphatemia
  • Renal Osteodystrophy

Also known as: Abnormally Decreased Blood Phosphate Level, Abnormally Decreased Serum Calcium, Condition Due To Low Levels Of Pth, Decreased Serum Calcium Due To Chronic Dialysis, Hyperparathyroidism Secondary To Crf, Hypocalcemia From End Stage Renal Disease With Dialysis, Hypocalcemia Secondary To Chronic Dialysis.

Dosing

During therapy with calcitriol, dosage depends on the nature and severity of the patient's hypocalcemia and must be individualized to maintain serum calcium concentrations of 9-10 mg/dL. The manufacturers recommend that serum calcium concentrations be measured at least twice weekly during initial dosage adjustments and after subsequent dosage changes; however, some clinicians recommend that serum calcium concentrations be measured at least weekly for the first 12 weeks of therapy and monthly after stabilization of dosage.

Nephrology experts state that the optimal intact parathyroid hormone (iPTH) concentration for patients with stage 3a (estimated glomerular filtration rate (eGFR) 45-59 mL/minute per 1.73 m2) to stage 5 (eGFR less than 15 mL/minute per 1.73 m2) chronic kidney disease (CKD) who are not undergoing dialysis is unknown, but modest increases in iPTH concentration may represent an appropriate adaptive response to declining renal function. For patients with stage 5 CKD undergoing dialysis, some experts suggest that iPTH concentrations may be maintained within a range of approximately 2-9 times the assay's upper limit of normal (ULN) (which may correspond to a range of approximately 130-600 pg/mL for commercially available assays ). Although some clinicians suggest that this range is too broad, available assays for PTH exhibit substantial variability; the previously recommended range of 150-300 pg/mL for patients with stage 5 CKD requiring dialysis was based on an assay that is no longer commercially available. Oversuppression of PTH may increase the risk of adynamic bone disease and should be avoided. (See Uses: Mineral and Bone Disorder Secondary to Chronic Renal Disease, in the Vitamin D Analogs General Statement 88:16.) Nephrology experts currently recommend that the individual values for serum calcium and phosphorus (evaluated together) be used instead of the mathematical construct of calcium times phosphorus product to guide clinical practice.

Drug interactions

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Contraindications

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Adverse reactions

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Precautions

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ICD codes

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Formulary status

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Last reviewed · Source: First Databank (FDB) drug data