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Alfacalcidol 💊
📖 About
Always check the BNF link here before prescribing.
- 💊 1-alpha hydroxycholecalciferol, a synthetic analogue of Vitamin D.
- ✅ Effective even in patients with renal disease (does not require renal hydroxylation at C-1 position).
⚡ Mechanism of Action
- 🔄 Alfacalcidol is rapidly converted in the liver to 1,25-dihydroxy Vitamin D (calcitriol).
- 🦴 Active metabolite enhances intestinal calcium absorption and promotes bone mineralisation.
- 🧬 Also modulates PTH secretion, useful in secondary hyperparathyroidism of CKD.
🩺 Indications & Dosing
- Vitamin D deficiency, particularly with renal impairment.
- Renal osteodystrophy & secondary hyperparathyroidism in CKD.
- ⚠️ Use lower doses in elderly due to higher hypercalcaemia risk.
- Typical starting dose: Alfacalcidol 1 mcg OD, maintenance usually 0.25–1 mcg/day.
💊 Dose Range (verify in BNF/datasheet)
| Name | Details |
|---|---|
| Alfacalcidol |
Starting dose: 0.25–1 microgram OD
Route: PO |
⚠️ Interactions
- ⬇️ Efficacy reduced by enzyme inducers such as phenytoin and barbiturates.
- 🧂 Concomitant calcium or phosphate supplements ↑ risk of hypercalcaemia/hyperphosphataemia.
⚠️ Cautions
- ⚡ Risk of hypercalcaemia (monitor U&E + calcium regularly).
- 🦴 May cause metastatic calcification or renal stones if calcium uncontrolled.
- 👴 Use with care in elderly or immobilised patients (higher hypercalcaemia risk).
🚫 Contraindications
- See BNF for full list – avoid if persistent hypercalcaemia present.
💥 Side Effects
- ⬆️ Hypercalcaemia and nephrocalcinosis.
- 🌡️ Rash, urticaria, pruritus (rare).
- 🩺 Symptoms of toxicity: nausea, vomiting, weakness, arrhythmias (due to hypercalcaemia).
📑 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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