Calcium Citrate + Calcitriol
Indications
Calcium Citrate + Calcitriol is used for:
Calcium and vitamin D3 supplement, Osteoporosis.
Adult Dose
Adult: PO: 1 tablet twice daily.
Child Dose
Renal Dose
Administration
Contra Indications
Patients with hypercalcaemia, hypercalciuria or hypophosphatemia. Nephrolithiasis, hypervitaminosis D.
Precautions
Impaired calcium absorption in achlorhydria which is common in elderly. Increased risk of hypercalcaemia and hypercalciuria in hypoparathyroid patients on high doses of vitamin D. History of kidney stones. Renal impairment.
Pregnancy-Lactation
Interactions
Reduced absorption of tetracyclines, quinolones and oral biphosphates with concurrent calcium use. Calcium absorption may be reduced by corticosteriods. Increased risk of hypercalcemia and metabolic alkalosis with thiazide diuretics. High blood calcium level may increase the effect of caridac glycosides. Reduced erlotinib efficacy with calcium. Increased risk of hypercalaemia with paricalcitol. Enzyme-inducing antiepileptics increases the metabolism of Vit D.
Potentially Fatal: Fatal encephalopathy can occur in patients with renal failure when given calcium citrate and aluminium products concurrently due to marked rise in aluminium levelCalcium salt can be used in the prevention and treatment of calcium deficiency states or negative calcium balance. It is also used as an adjunct in the prevention and treatment of osteoporosis.
Adverse Effects
Side effects of Calcium Citrate + Calcitriol :
Calcium
Anorexia, Constipation, Flatulence, Nausea, Vomiting, Hypercalcemia, Hypophosphatemia, Xerostomia, Acid rebound, Milk-alkali syndrome, Coma, Confusion, Delirium, Headache, Lethargy.
Calcitrol:
Abdominal pain, Apathy, BUN and creatinine increased, Cardiac arrhythmia, Constipation, Dry mouth, Dehydration, Growth suppression, Headache, Hyperthermia, Hypercalcemia, Hypercholesteremia, Hypermagnesemia, Hyperphosphatemia, Hypertension, Libido decreased, Metallic taste, Muscle or bone pain, Nocturia, Pruritus, Psychosis, Somnolence, Weakness
Mechanism of Action
Calcitriol promotes calcium absorption in the intestines and retention at the kidneys thus increasing serum calcium levels. It also increases renal tubule phosphate resorption consequently decreasing serum phosphatase levels, PTH levels and bone resorption.