📋 Indications & Clinical Dosage
*Renal osteodystrophy:*
Adult: Initially 250 nanograms daily, adjusted in steps of 250 nanograms every 2-4 weeks if required; usual dose 0.5-1 microgram daily
*Renal osteodystrophy (in patients with normal or only slightly reduced plasma-calcium concentration):*
Adult: Initially 250 nanograms once daily on alternate days, adjusted in steps of 250 nanograms every 2-4 weeks if required; usual dose 0.5-1 microgram daily
*Established postmenopausal osteoporosis:*
Adult: 250 nanograms twice daily, plasma-calcium concentration and creatinine to be monitored.
*Hypocalcaemia in patients undergoing dialysis or chronic renal failure. Reduction of parathyroid hormone in renal osteodystrophy:*
BY IV INJ: Adults: Initially: 0.5 mcg three times weekly by IV Inj at the end dialysis. Titrate: by 0.25 to 0.5 mcg at two to four wk intervals. Maintenance: 0.5-3 mcg three times weekly.
Children: Not recommended.
⛔ Contraindications
Hypercalcaemia, vit D toxicity.
⚠️ Precautions & Warnings
Maintain adequate calcium in take. Monitor serum calcium, phosphorous levels regularly; discontinue if hypercalcaemia occurs.
🔄 Drug Interactions
Vit D and derivatives, magnesium antacids, an
ticonvulsants, cardiac glycosides, barbiturates, corticosteroids.
⚠️ Adverse Reactions / Side Effects
Symptoms of vit D toxicity. Hypercalcaemia. Rarely, hypersensitivity.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
aution advised
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.