Philbone-A Phil medicine for osteoporosis, rickets (5 blisters x 10 tablets)

Dosage form Box of 5 blisters x 10 tablets
Specifications Calcitriol

Ingredient

Composition information	Content
Calcitriol	0.25mcg

Uses

Indications

Philbone-A drug is indicated in the following cases:

Osteoporosis. Learning

Calcitriol, one of the most active metabolites of Vitamin D3, normally formed in the kidney from its precursor is 25 - hydroxycholeciferol (25 -HCC). Normally, this amount is formed daily is 0.5 - 1.0mcg, 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.

pharmacokinetic

absorption

Calcitriol is quickly absorbed in the intestine. After taking a single dose of 0.25mcg to 1mcg 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 a single dose of 0.5mcg Calcitriol, the average serum concentration of Calcitriol increases from 40.0 ± 4.4pg/ml to 60.0 ± 4.4pg/ml, and reduced to 53.0 ± 6.9pg/ml after 4 hours, 50 ± 7.0pg/ml after 8 hours, 44 ± 4.6Pg 5.1pg/ml after 24 hours. Calcitriol and other metabolites of vitamin D are linked to specialized proteins of plasma during the blood transport process. Calcitriol has an exogenous origin through the placenta and excretion through breast milk.

Metabolism

Many different metabolites of calcitriol, showing the various effects of vitamin D, which has been identified: 1 alpha, 25-dihydroxy-24-oxo-golecalciferol, 1alpha, 24R, 25-trihydroxy-24-oxo-choleciferol, 1 alpha, 24R, 25-trihydroxololecerol, 1alpha, 25r-dihydroxycholeciferol-26, 23s-lactone, 1alpha, 25 dihydroxy-23-oxo-golecalciferol, 1 alpha, 25R, 26-trihydroxy-23-oxo-golecalciferol and 1Alpha-Hydroxy-23-Carboxy-24,25,26,27-Tetranorcholeciferol.

Elimination

The half -life of Calcitriol is about 5 - 8 hours in healthy people. 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 intravenous injection, Calcitriol is marked radioactive 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 radioactive in healthy people, about 10% of Calcitriol dose marked marked in urine. The total amount of elimination of radioactive activity in 6 days after the intravenous injection of Calcitriol is marked with radioactive accounting for about 16% in the urine and 49% in feces.

Before taking Philbone-A Phil medicine for osteoporosis, rickets (5 blisters x 10 tablets)

How to use

Oral drugs.

Dosage

Optimal dose for a day should be carefully adjusted for each patient depending on the calcium concentration in the blood of each patient.

In renal bone disorders

When the beginning of treatment, the dose for a day is 1 capsule (0.25mcg). Then, every day using 1 capsule (0.25mcg) is sufficient. If the response to the drug is shown in biochemical values and clinical symptoms that do not improve significantly, about 2-4 weeks away, an additional dose of 1 capsule (0.25mcg)/day can be increased. During this time, the test of blood calcium concentration must be conducted at least 2 times per week.

It is found that the dose is from 2 tablets (0.5mcg)/day to 4 tablets (1mcg)/day effectively in most patients.

In patients with normal or mitigated calcium calcium concentration, a dose of 0.25mcg (1 capsule) is sufficient. If within 2-4 weeks, responding to drugs shown in biochemical parameters and clinical developments that do not meet the desired level, then 2-4 weeks away, can increase the dose of 0.25mcg (1 tablet)/day. During this time, the test of blood calcium concentration must be conducted at least 2 times per week. Most patients have a good response at 0.5mcg (2 capsules) to 1mcg (4 tablets)/day.

If using Barbiturates or anti -epileptic drugs simultaneously with this drug, it is necessary to take a higher dosage. The effectiveness of treatment is partly dependent on the amount of calcium collected daily or not (in adults, about 800 - 1000mcg/day). If necessary, increase calcium by changing diet or adding calcium.

In osteoporosis

The recommended dose is 0.25mcg (1 tablet)/2 times a day. In case of failure to meet the desire, each month, the dose can be increased to a maximum of 2 tablets (0.5mcg)/ 2 times/ day. In the stage of determining the dose for the patient, it is necessary to check the blood calcium concentration at least 2 times per week and if the hypercalcemia occurs, it is necessary to stop taking the drug until the concentration of calcium blood returns to normal. The addition of calcium is almost unnecessary because the increased calcium absorption in post -menopausal patients using calcitriol.

In the case of thyroidism, rickets and bone puree

The starting dose is proposed as 1 capsule (0.25mcg)/day, drink every morning. If responded to drugs shown in biochemical testing values and clinical symptoms that have not improved significantly, every 2-4 weeks may increase the dose of 1 more capsule (0.25mcg)/day. In the stage of determining the dose for the patient, it is necessary to check the blood calcium concentration at least 2 times per week. It may be necessary to use higher doses because in patients with armoral disabilities, calcium absorption is sometimes very low.

General notes

After determining the optimal dose of the drug for the patient, blood calcium concentration needs to be checked once a month. When blood calcium concentration is more than normal 1mg/100ml (the average average value is 9 - 11mg/100 ml), the dose must be reduced immediately or stop taking the drug immediately until the concentration of calcium blood calcium returns to normal. Another effective way to bring blood calcium concentration quickly to normal levels is to stop other sources of calcium into the body. It is recommended that it is necessary to carefully consider reducing the source of calcium from the diet. When hypercalcemia occurs, it is necessary to check the concentration of calcium and phosphate daily. When blood calcium concentration returns to normal, you can use the drug again with a decrease dosage.

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? High calcium concentration in the epidemic reflects with hypercalcemia.

The overdose treatment measures due to the wrong oral intake includes: gastric lavage immediately or vomiting to avoid absorption of drugs into the blood. Use paraffin oil to increase the elimination of drugs through feces. 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. Note that it should not be used double the prescribed dose.

Side Effects

When using Philbone-A, you may experience unwanted effects (ADR).

If the dose has been determined for each patient depending on the symptoms of the disease, the side effects often do not occur unless the dose is exceeding the necessary dose.

Side effects and harmful reactions of the drug are similar to side effects and harmful reactions due to overdose of vitamin D: hypercalcemia and calcium poisoning. Sometimes acute symptoms such as anorexia, headache, vomiting and constipation.

Because the drug has a relatively short biological destruction time, the blood calcium concentration in pharmacokinetic studies can quickly return to normal after the drug stopped.

The following chronic symptoms can occur: malnutrition, sensory disorders, fever accompanied by thirst, multi -urius, dehydration, indifference, developmental retardation, urinary tract infection.

In the case of hypercalcemia and hyperemia occurs simultaneously, the lime chemistry in soft tissue may occur and may be diagnosed with a defined through X-ray image.

blood creatinine may increase in patients with normal renal function with prolonged hypercalcemia.

Hypersensitivity reactions to drugs may occur in sensitive people.

Instructions on how to handle ADR

Notify the doctor with unwanted effects when taking the drug.

Warnings

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

Contraindicated

Philbone-A drugs in the following cases:

All diseases are related to hypercalcemia.

Patients with a history of hypersensitivity to this drug or any ingredient of the drug.

Patients with signs of vitamin D poisoning.

Precautions when using

Children under 3 years old and are being hemorrhagic: Because the experience of using drugs in this case is not much, so only use drugs for these patients after considering the risks that may occur with the benefits of treatment.

The ability to drive and operate machinery

no effect.

Pregnancy

Because the safety of the drug for pregnant women or suspected pregnancy has not been determined, so only the medication for pregnant women or suspicion of pregnancy after comparing the risks may occur to the mother and fetus with the benefits of treatment.

Breastfeeding period

No report.

Medicinal interaction

should be avoided using Calcitriol combination with vitamin D and substances of vitamin D because it can lead to hypercalcemia.

The risk of hypercalcemia can increase if the drug is used simultaneously with thiazid compounds.

Patients taking Digitalis medication should be cautious when determining calcitriol dose because blood calcium hypercalcium can increase the development of arrhythmia.

Due to enamel induction substances such as phenytoin and phenobarbital, increasing Calcitriol metabolism, it is necessary to increase the dose of Calcitriol when used simultaneously with the above drugs.

cholestyramin reduces the absorption of oil -soluble vitamins, so it can reduce the absorption of this drug.

Storage

Storage in closed boxes, cool dry places, at temperatures below 30 ° C.

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