Dosing & Uses
Dosage Forms & Strengths
capsule
- 0.25mcg
- 0.5mcg
oral solution
- 1mcg/mL
injectable solution
- 1mcg/mL
Chronic Renal Dialysis Associated Hypocalcemia
Oral
- Initial: 0.25 mcg PO qDay to every other day; titrate by 0.5-1 mcg/day q4-8Weeks
IV
- Initial: 1-2 mcg IV (0.02 mcg/kg) 3 times/week; adjust dose every 2-4 weeks
- Maintenance: 0.5-4 mcg IV 3 times/week
Hypoparathyroidism/Pseudohypoparathyroidism
Initial: 0.25 mcg PO qDay; titrate by 0.25 mcg q2-4Weeks
Maintenance: 0.5-2 mcg PO qDay
Secondary Hyperparathyroidism
Moderate to severe kidney disease
- 0.25 mcg/day PO; may increase to 0.5 mcg/day; lower doses of 0.25 mcg 3 to 4 times per week also used
Chronic renal dialysis
-
Oral
- 0.25 mcg qDay; may increase by 0.25mcg/day at 4-8 week intervals, up to 0.5-1 mcg/day; patients with mildly decreased serum calcium levels may respond to 0.25 mcg every other day
-
Intravenous
- Initiate with caution; may consider 0.5 mcg 3 times weekly approximately every other day or if necessary higher doses at 1-2 mcg 3 times weekly approximately every other day; adjust dose by 0.5-1 mcg at 2-4 week intervals
- Maintenance: 0.5-4 mcg 3 times weekly
Vitamin D Dependent Rickets (Off-label)
1 mcg PO qDay
Administration
Goal is to maintain serum Ca 9-10 mg/dL
Doing Forms & Strengths
capsule
- 0.25mcg
- 0.5mcg
oral solution
- 1mcg/mL
injectable solution
- 1mcg/mL
Chronic Renal Dialysis Associated Hypocalcemia
0.25-2 mcg/day PO qDay
Hypoparathyroidism/Pseudohypoparathyroidism
<1 year: 0.04-0.08 mcg/kg PO qDay
1-5 years: 0.25-0.75 mcg PO qDay
>6 years: 0.5-2 mcg PO qDay
Familial Hypophosphatemia
Initial: 0.015-0.02 mcg/kg PO qDay
Maintenance: 0.03-0.06 mcg/kg PO qDay
No more than 2 mcg PO qDay
Secondary Hyperparathyroidism in Moderate to Severe Kidney Disease
<3 years: 0.01-0.015 mcg/kg/day
≥3 years: 0.25 mcg/day PO; may increase to 0.5 mcg/day
Hypocalcemia in Premature Infants
1 mcg qDay PO for 5 days
Vitamin D-Dependent Rickets (Off-label)
0.5 mg PO twice daily; adjust dose to maintain normal serum calcium and PTH levels; after 2 years, median dose is 0.25 mcg/day
Hypocalcemic Tetany in Premature Infants (Off-label)
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (22)
- apalutamide
apalutamide will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
- atazanavir
atazanavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- carbamazepine
carbamazepine will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- darunavir
darunavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- enzalutamide
enzalutamide will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.
- idelalisib
idelalisib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
- indinavir
indinavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- itraconazole
itraconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.
- lonafarnib
lonafarnib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
- lopinavir
lopinavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- mifepristone
mifepristone will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nafcillin
nafcillin will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nefazodone
nefazodone will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nelfinavir
nelfinavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- pacritinib
calcitriol will decrease the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- posaconazole
posaconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- ritonavir
ritonavir will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- tucatinib
tucatinib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
- voxelotor
voxelotor will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
Monitor Closely (40)
- amobarbital
amobarbital will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atogepant
calcitriol will decrease the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- axitinib
calcitriol decreases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- belzutifan
belzutifan will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
- bosentan
bosentan will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ceritinib
ceritinib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- crofelemer
crofelemer increases levels of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.
- dabrafenib
dabrafenib will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- dienogest/estradiol valerate
calcitriol will decrease the level or effect of dienogest/estradiol valerate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Advise women to use alternative method of contraception or back-up method when moderate or weak enzyme inducer is used with combination contraceptives. Back-up contraception should be continued for 28 days after discontinuing medication to ensure contraceptive reliability.
- duvelisib
duvelisib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of
- efavirenz
efavirenz will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- elagolix
elagolix will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
- encorafenib
encorafenib, calcitriol. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
- etravirine
etravirine will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fedratinib
fedratinib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
- fosphenytoin
fosphenytoin will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- iloperidone
iloperidone increases levels of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.
- isavuconazonium sulfate
calcitriol will decrease the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- istradefylline
istradefylline will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
- ketoconazole
ketoconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- levoketoconazole
levoketoconazole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- linagliptin
calcitriol will increase the level or effect of linagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use of alternative treatments is strongly recommended when linagliptin is to be administered with a CYP3A4 inducer
- lorlatinib
lorlatinib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- magnesium supplement
magnesium supplement will increase the level or effect of calcitriol by Other (see comment). Modify Therapy/Monitor Closely. Drug may increase absorption of magnesium in the intestine and colon, which increases risk of hypermagnesemia
- mitotane
mitotane will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- phenobarbital
phenobarbital will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- phenytoin
phenytoin will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- primidone
primidone will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ribociclib
ribociclib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rucaparib
rucaparib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
- secobarbital
secobarbital will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
calcitriol increases levels of sodium sulfate/?magnesium sulfate/potassium chloride by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.
- sodium sulfate/potassium sulfate/magnesium sulfate
calcitriol increases levels of sodium sulfate/potassium sulfate/magnesium sulfate by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.
- stiripentol
stiripentol, calcitriol. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
- tazemetostat
tazemetostat will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
calcitriol will decrease the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - tecovirimat
tecovirimat will decrease the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
- tinidazole
calcitriol will decrease the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ubrogepant
calcitriol will decrease the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose adjustment is recommended with concomitant use of ubrogepant and moderate and weak CYP3A4 inducers. (see Dosage Modifications)
Minor (4)
- acetazolamide
acetazolamide will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- anastrozole
anastrozole will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- cyclophosphamide
cyclophosphamide will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- larotrectinib
larotrectinib will increase the level or effect of calcitriol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
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
N/V
Nocturia
Pruritus
Psychosis
Somnolence
Weakness
Warnings
Contraindications
Hypercalcemia or evidence of vitamin D toxicity
Hypersensitivity to calcitriol, other vitamin D analogues, or other ingredients
Cautions
Other vitamin D compounds should be withheld during treatment in order to avoid the development of hypervitaminosis D; excessive vitamin D may suppress parathyroid hormone
If patients are "changed over" from ergocalciferol to calcitriol it may take many months for blood levels of ergocalciferol to return to pre-treatment values; overdosage of any form of vitamin D is dangerous; chronic hypercalcemia can lead to generalised vascular calcification, nephrocalcinosis and other soft-tissue calcification
Patients with hypophosphatemic rickets (familial hypophosphatemia) should pursue their oral phosphate therapy; however, the possible stimulation of intestinal phosphate absorption may modify the requirement for phosphate supplements; during the stabilisation phase of treatment, serum calcium levels should be checked at least twice weekly
Efficacy may be unpredictable in patients with malabsorption syndrome
Sudden increases in calcium consumption due to dietary change (eg, dairy products) or injudicious calcium supplements may precipitate hypercalcaemia; patients and relatives should receive instruction in dietary management, be informed about symptoms of hypercalcaemia, and be warned of consequences of not adhering to dietary recommendations
In patients with normal renal function, chronic hypercalcaemia may be associated with an increase in serum creatinine
Therapy raises serum inorganic phosphate levels; while this is a desirable effect in patients with hypophosphatemic states, caution must be taken in patients with renal failure
Calcitriol may increase plasma phosphate levels; while this effect is desirable in hypophosphatemic osteomalacia, it may cause ectopic calcification, especially in patients with renal failure; plasma phosphate levels should be kept normal in such patients by the oral administration of phosphate binding agents
Patients with normal renal function should avoid dehydration; adequate fluid intake should be maintained
Use caution in malabsorption syndrome, renal/hepatic impairment
Patients immobilized after surgical procedures are more at risk of developing hypercalcaemia, therefore more frequent monitoring is recommended
Special care should be taken when administering therapy to patients with renal dysfunction; more frequent monitoring in these patients is appropriate
In elderly patients suffering from ischemic heart disease, serum calcium levels should be carefully monitored; if hypercalcemia is observed, therapy should be suspended immediately; it should also be remembered that geriatric patients receive many other drugs and that their compliance may not be ideal
Pregnancy & Lactation
Pregnancy category: C
Lactation: Enters breast milk; not recommended
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Calcitriol is a potent metabolite to the active form of vitamin D, which in turn controls the reabsorption of calcium by the kidneys, controls the intestinal absorption of dietary calcium; decreases excessive serum phosphate levels, bone resorption, and parathyroid hormone levels
Absorption
Onset of action: 2-6 hr (PO)
Peak plasma time: 3-6 hr
Duration: 3-5 days (PO/IV)
Distribution
Protein bound: 99.9%
Metabolism
24-hydroxylase to calcitroic acid; also by stepwise hydroxylation to vitamin D3 lactone ring
Elimination
Half-life elimination: 5-8 hr (adults); 27 hr (children)
Excretion: Feces (50%); urine (16%)
Administration
IV Administration
Rapid injection through catheter at end of hemodialysis
Usually single daily dose
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Rocaltrol oral - | 0.5 mcg capsule |  | |
| Rocaltrol oral - | 1 mcg/mL solution |  | |
| Rocaltrol oral - | 0.25 mcg capsule |  | |
| calcitriol oral - | 0.5 mcg capsule |  | |
| calcitriol oral - | 0.25 mcg capsule |  | |
| calcitriol oral - | 0.5 mcg capsule |  | |
| calcitriol oral - | 1 mcg/mL solution |  | |
| calcitriol oral - | 0.5 mcg capsule |  | |
| calcitriol oral - | 0.25 mcg capsule |  | |
| calcitriol oral - | 0.25 mcg capsule |  | |
| calcitriol oral - | 0.5 mcg capsule |  | |
| calcitriol oral - | 0.25 mcg capsule |  | |
| calcitriol oral - | 1 mcg/mL solution |  | |
| calcitriol oral - | 0.25 mcg capsule |  | |
| calcitriol topical - | 3 mcg/gram ointment |  | |
| Vectical topical - | 3 mcg/gram ointment |  | |
| calcitriol intravenous - | 1 mcg/mL solution |  | |
| calcitriol intravenous - | 1 mcg/mL solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
calcitriol oral
CALCITRIOL - ORAL
(KAL-si-TRYE-ol)
COMMON BRAND NAME(S): Rocaltrol
USES: Calcitriol is a man-made active form of vitamin D. Most people get enough vitamin D from exposure to the sun and from fortified food products (such as dairy products, vitamins). Vitamin D helps control parathyroid hormone and the levels of certain minerals (such as calcium, phosphorus) that are needed for building and keeping strong bones.Before regular vitamin D can be used by the body, it needs to be changed to the active form by the liver and kidneys. Calcitriol is used in patients with kidney disease who can't make enough of the active form of Vitamin D. This medication is also used to prevent and treat certain types of calcium/phosphorus/parathyroid problems that can happen with long-term kidney dialysis or hypoparathyroidism. Calcitriol is usually used along with specific diet recommendations and sometimes other medications.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once daily. If you are using the liquid form, measure your dose with a special measuring spoon or device. Do not use a normal household spoon since you may not get the correct dose.Dosage is based on your medical condition and response to therapy. Your doctor may start you on a low dose and adjust the dose slowly to find the best dose for you. Follow your doctor's directions carefully. Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.It is very important to follow the diet recommended by your doctor to get the most benefit from this medication and to prevent serious side effects. Do not take other supplements/vitamins (such as calcium, vitamin D) unless ordered by your doctor.Certain medications (bile acid sequestrants such as cholestyramine/colestipol, mineral oil, orlistat) can decrease the absorption of vitamin D. Separate your doses of these medications as far as possible from your doses of calcitriol (at least 2 hours apart, longer if possible). It may be easiest to take calcitriol at bedtime if you are also taking these other medications. Ask your doctor or pharmacist about finding a good dosing schedule that will work with all your medications.
SIDE EFFECTS: Calcitriol does not usually have side effects. Your doctor may check your calcium and phosphate blood levels and adjust your dose if you have side effects.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: loss of appetite, back/bone/joint/muscle pain, constipation, dry mouth, eye pain/redness/sensitivity to light, headache, fast/slow/irregular heartbeat, nausea/vomiting/diarrhea, sleepiness, stomach/abdominal pain, increased thirst, signs of kidney problems (such as change in the amount of urine), weakness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking calcitriol, tell your doctor or pharmacist if you are allergic to it; or to other vitamin D products; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high calcium levels, heart disease (such as irregular heartbeat, coronary artery disease), kidney disease (such as kidney stones).Notify your doctor beforehand if you will be having surgery or will be confined to a chair/bed (immobile) for a long time. Being immobile for long periods of time increases your risk of side effects.Be sure to drink plenty of fluids unless otherwise directed by your doctor.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: burosumab, cardiac glycosides (such as digoxin, digitalis), magnesium-containing medications (such as antacids, milk of magnesia), phosphate binders, vitamins/nutritional supplements (especially calcium and vitamin D), drugs that can speed up the removal of calcitriol from your body (such as ketoconazole, phenobarbital, phenytoin).Check the labels on all your prescription and nonprescription/herbal products (such as antacids, laxatives, vitamins) because they may contain calcium, magnesium, phosphate, and vitamin D. Ask your pharmacist about using those products safely.Calcitriol is very similar to other forms of vitamin D. Do not use medications containing other forms of vitamin D while using calcitriol.This medication may interfere with certain lab tests (such as cholesterol test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: weakness, headache, loss of appetite, metallic taste, nausea, vomiting, stomach cramps, dizziness.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as calcium, magnesium, phosphorus, parathyroid levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Foods rich in vitamin D include: fortified dairy products, eggs, sardines, cod liver oil, chicken livers and freshwater fish. Vitamin D is also obtained from periodic exposure to the sun.It is important to maintain a well-balanced diet while taking this medication. Calcium supplements may be recommended in addition to this medication. The usual recommendation for calcium is 600 to 1200 milligrams per day. Discuss this with your doctor. Do not take supplements unless directed by your doctor.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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