Calcitriol Ha Tay treatment for osteoporosis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Calcitriol
Ingredient Hypoxemia, osteoporosis, hypothyroidism, rickets

Ingredient

Composition information	Content
Calcitriol	0.25mcg

Uses

indications

Calcitrol drugs are indicated in the following cases:

Osteoporosis after menopause. Reduce blood phosphate. Normally, this amount is formed daily is 0.5 - 1.0 mg, and increases more in the period when bone formation increases (for example, during growth or pregnancy). Calcitriol facilitates the absorption of calcium in the intestine and regulates bone mineralization.

Calcitriol plays a key role in the air -conditioning regulation of calcium, while stimulating bone formation, this is a pharmacological facility for the treatment of osteoporosis.

In patients with severe renal failure, endogenous calciol synthesis and can stop completely. Lack of calcitriol in this case is the main cause of bone dysplasia caused by kidney.

In patients with kidney osteoporosis, calcitriol oral calciols normalize the absorption of calcium that have been impaired in the intestine, thus adjusting the condition of lowering blood calcium and high concentrations in the serum of alkaline phosphate and hypoglycary hormones. Calcitriol reduces bone and muscle pain, regulates histological deviations in fibrous and other disorders of mineralization.

In patients with undergarcticated parathyroidism, spontaneous parathyroidism or fake parathyroidism, using calcitriol will reduce blood calcium as well as improve clinical symptoms.

In patients with rickets that respond to vitamin D, the concentration of calcitriol in low serum, not even. Because the creation of endogenous calcitriol in the kidney is not enough, the use of CaiCitriol must be considered as an alternative therapy.

In patients with rickets that do not respond to vitamin D (rickets decrease in primary blood phosphate), in combination with low calciiol levels in plasma, Calcitriol treatment reduces the elimination of phosphate through the renal tubules and normally the bone formation due to the supplementation of phosphor sources.

In addition, Calcitriol's treatment is useful in patients with other types of rickets, such as rickets associated with hepatitis in infants, lack of biliary tract development, cystin dystrophy or calcium and vitamin D in incomplete food.

pharmacokinetics

absorption:

Calcitriol is quickly absorbed in the intestine. After taking the only dose of 0.25 to 1 mcg Calcitriol, the maximum concentration achieved after 3 to 6 hours.

After repeated drink, Calcitriol's concentration in serum reaches equilibrium after 7 days.

Distribution:

Two hours after taking the single dose of 0.5 mcg calcriol, the average concentration in the serum of calcitriol increases from 40.0 +/- 4.4 PG/mL to 60.0 +/- 4.4 PG/ml, and reduced to 53.0 +/- 6.9 PG/mL after 4 hours, 50 +/- 7.0 PG/mL after 8 hours, 4.6 PG/4.6 5.1 PG/ mL after 24 hours.

Calcitriol and other metabolites of Vitamin D are linked to specialized proteins of plasma during blood transport.

Calcitriol has an exogenous origin through the placenta fence and excreted through breast milk.

Metabolism:

Many different metabolites of calcitriol, showing the various effects of vitamin D, which has been identified: 1A, 25 - dihydroxy - 24 - Oxo - Cholecalciferol, 1A, 24R, 25 - Trihydroxy - 24 - Oxo - Cholecalciferol, 1A, 24R, 25 - Trihydroxycholecerol, 1A, 25R, 25R, 25R - 25R - 25R - 25R -, 25R - 25R -, 25R, 1A dihydroxycholeciferol - 26, 23s - lactone, 1A, 25s, 26 - trihydroxycholeciferol, 1A, 25 - dihydroxy - 23 - Oxo - Cholecalciferol, 1A, 25R, 26 - Trihydroxy - 23 - Oxo - Cholecalciferol and 1A - Hydroxy - 24, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25, 25 27 - Tetranorcholecalciferol.

Elimination:

The half -life of Calcitriol elimination is about 9 to 10 hours. However, the time to maintain the pharmacological effect of a single dose is about 7 days. Calcitriol is excreted through bile and influenced by the liver - intestinal cycle.

24 hours after the intravenous injection of Calcitriol is marked with radiation in healthy people, about 27% of radioactive activity is found in feces and about 7% in urine. 24 hours after taking the dose of 1 mcg Calcitriol is marked with radiation in healthy people, about 10% of the dose of Calcitriol has marked found in the urine.

The total amount of elimination of radioactive activity for 6 days after the intravenous injection of Calcitriol is marked with radioactive, accounting for about 16% in urine and 36% in feces.

Before taking Calcitriol Ha Tay treatment for osteoporosis (3 blisters x 10 tablets)

How to use

oral medication.

Dosage

Usual dose:

The usual starting dose of Calcitriol is 0.25 mcg/ day.

Carefully determine the optimal daily dose of calcitriol for each patient according to blood calcium.

As soon as you have found the optimal dose of calcitriol, blood calcium must be checked every month.

When the calcium concentration in serum exceeds 1 mg/ 100ml (or 0.25 mmol/ l), the dose is reduced or temporarily stopped using calcitriol until the calcium blood calcium returns to normal.

When values return to normal, it is possible to use Calcitriol at a dose lower than 0.25 mcg than previous use.

Special instructions on dosage:

Osteoporosis after menopause:

The recommended dose is 0.25 mcg, 2 times/ day, taking non -chewing pills. In patients provided by 500 mg of calcium from food, adding calcium. The amount of calcium provided daily does not exceed 1000 mg.

Seruminine and creatinine concentrations in serum must be checked in the 4th week, 3rd month and the 6th month, then every 6 months.

Bone nourishment is derived from the kidneys (patients with dialysis):

Daily starting dose is 0.25 mcg.

In people with normal blood calcium or mild blood calcium, taking a dose of 0.25 mcg every 2 days is enough.

If clinical and biochemical parameters do not progress in a good direction after about 2 to 4 weeks, daily dose can be added 0.25 mcg after 2 to 4 weeks.

During this period, it is necessary to check the calcium concentration in plasma at least 2 times per week. Most patients have a good response to the dose of 0.5 to 1 mcg/ day. High doses may be taken if combined with barbiturates or anti -epileptic drugs.

Missing parathyroid and rickets:

The recommended starting dose is 0.25 mcg/ day, drink in the morning.

If clinical and biochemical parameters do not progress in a good way, daily dose can be added by 0.25 mcg after 2 to 4 weeks. During this period, it is necessary to check the calcium concentration in plasma at least 2 times per week.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Overdose:

Treatment of asymptomatic blood calcium hypertension: Calcitriol is a metabolic substance of vitamin D, all cases of calcitriol overdose will give similar clinical symptoms as overdose of vitamin D. High calcium concentration in the epidemic reflects with hypercalcemia.

Signs of acute poisoning vitamin D: anorexia, headache, nausea, constipation.

Signs of chronic poisoning: Dehydration (weakness, weight loss), disorders of senses, may have a fever accompanied by thirst, multi -urinary, dehydration, insensitivity, growth and urinary tract infection. Chronic poisoning will cause secondary hypercalcemia with calcification of the kidney, heart muscle, lung and pancreatic.

How to handle:

Stomach was immediately or vomiting to avoid absorbing the drug into the blood. Use paraffin oil to increase the elimination of the drug. Conduct multiple blood calcium tests. If blood calcium is still high, can use phosphate and corticosteroids, and use appropriate measures to increase the urinary tract.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using Calcitriol, you may experience unwanted effects (ADR).

Calcitriol does not cause any adverse effects if not too much of the body's needs. However, like Vitamin D, if using a high -dose calcitriol can cause adverse effects similar to when overdose of vitamin D: blood calcium hypercactive syndrome or calcium poisoning, depending on the degree and time of hypercalcemia.

If simultaneously hypercalcemia and hyperactive phosphate (> 6 mg/ 100 ml, or> 1.9 mmol/ l) may cause calcification of software, which can be noticed through X -rays.

Due to the short half -life, the normalization of a high concentration of calcium in plasma only takes a few days after the drug is stopped, much faster than vitamin D3.

Instructions on how to handle ADR

Notify the doctor with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Calcitriol drugs are contraindicated in the following cases:

Contraindicated Calcitriol (or all drugs in the same group) in diseases related to hypercalcemia, as well as when hypersensitivity to one of the ingredients of the drug.

Calcitriol is also contraindicated if there are clear signs of vitamin D poisoning.

Be cautious when used

between calcitriol treatment and hypercalcemia have strict correlation. In studies on bone dysplasia originating from the kidneys, nearly 40% of patients are treated with calcitriol with hypercalcemia.

If a sudden increase in calcium provides due to changing eating habits (such as eating or drinking many milk products) or uncontrolled drugs that contain calcium may cause blood calcium hyperglycemia. It is recommended that patients follow the diet well and notify the patient about the symptoms of blood calcium hypertension.

Patients lying immobilized for a long time, for example after surgery, easily at risk of hypercalcemia.

Patients with normal kidney function, if chronic calcium hypercalcemia occurs, may be combined with serum anemia.

Particularly cautious when used for patients with a history of kidney stones or coronary artery disease.

Calcitriol increases the concentration of inorganic phosphate in serum. While this effect is expected in patients with hypoglycemic phosphate, caution needs to be careful in patients with renal failure, due to the risk of calcification. In these cases, it is recommended to maintain the normal plasma phosphate levels (2 to 5 mg/ 100 ml, equivalent to 0.65 to 1.62 mmol/ l) by using chelate complex substances with phosphor like hydroxyd or carbonate.

In patients with Vitamin D resistant rickets (rickets decreased by family blood phosphate) and are treated with calcitriol, should continue to use oral phosphate. However, it is also advisable to pay attention to the possibility of Calcitriol may stimulate the absorption of phosphate in the intestine, as this can change the needs of additional phosphate.

Should regularly check the concentrations of calcium, phosphor, magnesi and alkaline phosphate in serum, as well as the concentration of calcium and phosphate in urine for 24 hours. In the early stages of calcitriol treatment, plasma concentration should be checked at least 2 times per week (see the dose).

Calcitriol is the most active metabolic substance of vitamin D, so it should not be used with other drugs containing vitamin D during Calcitriol treatment, to avoid possible increase in vitamin D pathology.

If transferred from Ergocalciferol (vitamin D2) treatment through Calcitriol treatment, it may take months for the concentration of Ergocalciferol to return to the original value (see what to do when overdose).

Patients with normal kidney function treated with Calcitriol should note that dehydration may occur, and should drink enough water.

The ability to drive and operate machinery

On the basis of the pharmacological records of the reported side effects, this product is thought to be safe or unable to adversely affect the ability to drive and operate machinery.

Pregnancy

A animal toxicity studies do not give convincing results, no relatively controlled studies in humans on the effects of Calcitriol of exogenous origin on pregnancy and fetal development. Therefore, using Calcitriol only when the benefits are much higher than the risk of fetus.

The period of breastfeeding

Calcitriol is excreted in breast milk, which can cause adverse effects for children, so they should not breastfeed during treatment with Calcitriol.

Drug interaction

Calcitriol is one of the main metabolites that have the activity of vitamin D, so it is not advisable to coordinate with vitamin D or derivatives, in order to avoid the force of force that may occur with the risk of hypercalcemia.

Should obey the doctor's advice well about the diet, mainly foods can provide multiple calcium, avoiding drugs containing calcium.

Concentrated with thiazid diuretics increases the risk of hypercalcemia in patients with parathyroid disabilities, in patients being treated with digitalis, should identify calcitriol dose carefully, due to hypercalcemia may launch arrhythmia.

There is a functional antagonist between vitamin D and corticosteroid substances: Vitamin D substances are favorable for calcium absorption, while corticosteroids inhibit this process.

To avoid increased blood magnesium, avoid patients with chronic dialysis, which contain magnesium (such as antacids) during Calcitriol treatment.

Calcitriol also affects the transportation of phosphate in the intestine, kidney and bone; Using chelate complexes with phosphate must be adjusted according to the serum concentration of phosphate (normal value: 2 - 5 mg/ 100 ml, equivalent to 0.6 - 1.6 mmol/ l).

In patients with anti -Vitamin D rickets (rickets decrease in family blood phosphate), oral phosphate should be continued. However, it should be noted that Calcitriol can stimulate the absorption of phosphate in the intestine, so it can reduce the need for additional phosphate.

Using enzyme -causing drugs such as phenytoin or phenobarbital may increase the metabolism of calcitriol and thus reduces the concentration of this substance in serum.

Colestyramin can reduce the absorption of oil -soluble vitamins and thus also affects the absorption of Calcitriol.

Storage

In a dry place, temperatures below 30 ° C.

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