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 : 400.6

%Protein binding : Extensive plasma protein binding

%Excreted unchanged in urine : 13

Volume of distribution (L/kg) : No data

half-life – normal/ESRD (hrs) : <3/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Not dialysed. Dose as in normal renal function

HD : Dialysed. Dose as in normal renal function

HDF/high flux : Dialysed. Dose as in normal renal function

CAV/VVHD : 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

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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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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