Calcitriol

Calcitriol Brand Names

Calcijex | Rocaltrol | Vectical

What is Calcitriol

Calcitriol, or 1,25-dihydroxycholecalciferol, is the active form of vitamin D₃ (cholecalciferol) and is available for oral, topical, and intravenous use. Calcitriol is structurally similar to calcifediol; however, calcitriol has more than twice the vitamin D activity of calcifediol.

Vitamin D occurs in two primary forms: cholecalciferol (vitamin D₃), which is synthesized in the skin after exposure to ultraviolet light, and ergocalciferol (vitamin D₂), which is produced from plant sterols and is the primary dietary source of vitamin D.

Many vitamin D analogs are commercially available, but the responsiveness of various conditions differs based on the pharmacologic properties of each vitamin D analog.

Calcitriol is preferable to calcifediol in the management of hypocalcemia in dialysis-dependent renal failure patients because calcifediol must be activated by healthy kidneys to be effective.

Calcitriol is indicated for the treatment of secondary hyperparathyroidism and the resultant metabolic bone disease in chronic renal failure patients who are not receiving dialysis; calcitriol also has been used in hypoparathyroidism, familial hypophosphatemia, and vitamin D-dependent rickets.

In addition, a topical formulation is used for the treatment of plaque psoriasis. Systemic calcitriol was approved by the FDA in 1978.

Calcitriol ointment (Vectical) was approved by the FDA in January 2009.

Indications

1. hyperparathyroidism
2. hypocalcemia
3. hypoparathyroidism
4. hypophosphatemia
5. osteopetrosis
6. osteoporosis
7. osteoporosis prophylaxis
8. psoriasis
9. renal osteodystrophy
10. rickets
11. vitamin D deficiency

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. anaphylactoid reactions
4. anorexia
5. arthralgia
6. ataxia
7. constipation
8. contact dermatitis
9. dehydration
10. diarrhea
11. erythema
12. erythema multiforme
13. fatigue
14. growth inhibition
15. headache
16. hypercalcemia
17. hypercalciuria
18. hyperphosphatemia
19. hypertension
20. hyperthermia
21. hypervitaminosis D
22. injection site reaction
23. irritability
24. libido decrease
25. metallic taste
26. myalgia
27. nausea
28. nephrolithiasis
29. photophobia
30. polydipsia
31. polyuria
32. pruritus
33. psoriasis
34. rash
35. rhinorrhea
36. tinnitus
37. urticaria
38. vertigo
39. vomiting
40. weakness
41. xerostomia

Monitoring Parameters

• 24-hour urinary calcium
• serum calcium
• serum creatinine/BUN
• serum intact parathyroid hormone concentrations (iPTH)
• serum phosphate

Contraindications

• accidental exposure
• arteriosclerosis
• breast-feeding
• cardiac disease
• dehydration
• geriatric
• hypercalcemia
• hyperphosphatemia
• hypervitaminosis D
• occlusive dressing
• ocular exposure
• pregnancy
• renal failure
• sarcoidosis
• sunlight (UV) exposure

Interactions

• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiloride; Hydrochlorothiazide, HCTZ
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Atenolol; Chlorthalidone
• Azilsartan; Chlorthalidone
• Barbiturates
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Burosumab
• Calcifediol
• Calcitonin
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Chlorothiazide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cholestyramine
• Chromium
• Colestipol
• Digoxin
• Dihydrotachysterol
• Doxercalciferol
• Enalapril; Hydrochlorothiazide, HCTZ
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erdafitinib
• Ethotoin
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Hetastarch; Dextrose; Electrolytes
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Ibritumomab Tiuxetan
• Ketoconazole
• Magnesium
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salts
• Methyclothiazide
• Metolazone
• Mineral Oil
• Orlistat
• Paricalcitol
• Phenytoin
• Phosphorated Carbohydrate Solution
• Phosphorus
• Polycarbophil
• Porfimer
• Potassium Phosphate
• Potassium Phosphate; Sodium Phosphate
• Thiazide diuretics
• Verteporfin