Calcitriol: Difference between revisions
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[[Category:Vitamin D analogs]] | |||
[[Category:Hormones]] | |||
Latest revision as of 10:43, 23 May 2026
Calcitriol (1,25-dihydroxyvitamin D3)
Rocaltrol (oral), Calcijex (IV); topical Vectical for psoriasis
Experience
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Summary
Common uses
Secondary hyperparathyroidism in CKD0, Hypocalcemia in hypoparathyroidism0, Renal osteodystrophy0, Vitamin D-resistant rickets0, Plaque psoriasis (topical)0
Pharmacy
Starting dose
Oral 0.25 mcg daily, titrate by serum calcium and PTH; IV in CKD 0.5-3 mcg three times weekly
Preparations
0.25, 0.5 mcg oral capsules; 1 mcg/mL oral solution; 1 mcg/mL IV; 3 mcg/g topical ointment
US FDA Max
Titrated; risk of hypercalcemia is the limiting factor
Pharmacology
Routes
Oral, IV, topical
Onset
Days for calcium effect; weeks for PTH suppression
Duration
Hours per dose (much shorter biologic effect than ergocalciferol/cholecalciferol because it is the already-active form, not the storage form)
Half-life
~5-8 hours[1]
Bioavailability
High (oral)[1]
Pregnancy
Used when needed for hypoparathyroidism or renal osteodystrophy in pregnancy.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Calcitriol is the biologically active form of vitamin D (1,25-dihydroxyvitamin D3); it binds the vitamin D receptor (VDR) to drive transcription of genes governing intestinal calcium absorption, renal calcium reabsorption, bone calcium mobilization, and parathyroid PTH gene expression suppression.0 Bypasses the renal CYP27B1 hydroxylation step that fails in advanced CKD, making it (and 1α-hydroxylated analogs like paricalcitol) the active replacement for renal failure. Hypercalcemia is the dose-limiting adverse effect — frequent monitoring of calcium, phosphate, and PTH is standard[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Rocaltrol (calcitriol), Validus, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017636s048lbl.pdf