Alfacalcidol

CLINICAL USE


Vitamin D analogue:

  • Increase serum calcium levels
  • Inhibition of parathyroid hormone release
  • Suppression of PTH production

    DOSE IN NORMAL RENAL FUNCTION


    0.25–1 microgram daily according to
    responseAlternatively, up to 4 micrograms 3
    times a week

    PHARMACOKINETICS


  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    400.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Extensive plasma
    protein binding
  • %Excreted unchanged in urine &nbsp &nbsp :
    13
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
    No data
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
    <3/–

    DOSE IN RENAL IMPAIRMENT


    GFR (mL/MIN)


  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES


  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    Not dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Dialysed. Dose as in normal renal
    function
  • HDF/high flux &nbsp :
    Dialysed. Dose as in normal renal
    function
  • CAV/VVHD &nbsp &nbsp &nbsp:
    Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS


    Potentially hazardous interactions with other drugs

  • Carbamazepine, phenytoin, phenobarbital

    and primidone may increase metabolism
    of alfacalcidol, necessitating larger doses
    than normal to produce the desired effect

    ADMINISTRATION


    Reconstition



    Route


    O, IV

    Rate of Administration


    Over 30 seconds

    Comments



    OTHER INFORMATION

  • Adjust dose according to responseSerum

    calcium ref range 2.1–2.6 mmol/L (total)
    An IV preparation (2 micrograms/mL) and

    an oral solution (2 micrograms/mL) are
    also available

  • Doses of 1 microgram daily for 5 days

    may need to be given immediately prior
    to parathyroidectomy. Alternatively,
    give 5 micrograms immediately prior to
    parathyroidectomy

  • Capsules of One-Alfa (Leo) contain

    sesame oil