Yes

Vitamin D Analog

Treatment of hypocalcemia associated with hypoparathyroidism; prophylaxis of hypocalcemic tetany following thyroid surgery

A/D (if dose exceeds RDA recommendation)

Hypercalcemia, known hypersensitivity to dihydrotachysterol

Calcium-phosphate product (serum calcium and phosphorus) must not exceed 70; avoid hypercalcemia; use with caution in coronary artery disease, decreased renal function (especially with secondary hyperparathyroidism), renal stones, and elderly

>10%:

Endocrine & metabolic: Hypercalcemia

Renal: Elevated serum creatinine, hypercalciuria

<1%: Convulsions, polydipsia, nausea, vomiting, anorexia, weight loss, polyuria, anemia, weakness, metastatic calcification, renal damage

Symptoms of overdose include hypercalcemia, anorexia, nausea, weakness, constipation, diarrhea, vague aches, mental confusion, tinnitus, ataxia, depression, hallucinations, syncope, coma; polyuria, polydypsia, nocturia, hypercalciuria, irreversible renal insufficiency or proteinuria, azotemia; will spread tissue calcifications, hypertension

Following withdrawal of the drug, treatment consists of bed rest, liberal intake of fluids, reduced calcium intake, and cathartic administration. Severe hypercalcemia requires I.V. hydration and forced diuresis. Urine output should be monitored and maintained at >3 mL/kg/hour. I.V. saline can quickly and significantly increase excretion of calcium into the urine. Calcitonin, cholestyramine, prednisone, sodium EDTA and mithramycin have all been used successfully to treat the more resistant cases of vitamin D-induced hypercalcemia.

Decreased effect/levels of vitamin D: Cholestyramine, colestipol, mineral oil; phenytoin and phenobarbital may inhibit activation and decrease effectiveness

Increased toxicity: Thiazide diuretics increase calcium

Protect from light

Synthetic analogue of vitamin D with a faster onset of action; stimulates calcium and phosphate absorption from the small intestine, promotes secretion of calcium from bone to blood; promotes renal tubule resorption of phosphate

Peak hypercalcemic effect: Within 2-4 weeks

Duration: Can be as long as 9 weeks

Absorption: Well absorbed from the GI tract

Elimination: In bile and feces; stored in liver, fat, skin, muscle, and bone

Oral:

Infants and young Children: Initial: 1-5 mg/day for 4 days, then 0.1-0.5 mg/day

Older Children and Adults: Initial: 0.8-2.4 mg/day for several days followed by maintenance doses of 0.2-1 mg/day

Nutritional rickets: 0.5 mg as a single dose or 13-50 mcg/day until healing occurs

Renal osteodystrophy: Maintenance: 0.25-0.6 mg/24 hours adjusted as necessary to achieve normal serum calcium levels and promote bone healing

Monitor renal function, serum calcium, and phosphate concentrations; if hypercalcemia is encountered, discontinue agent until serum calcium returns to normal

Calcium (serum): 9-10 mg/dL (4.5-5 mEq/L)

None reported

Concurrent use with phenytoin or phenobarbital may decrease effectiveness

No information available to require special precautions

No effects or complications reported

Take exact dose prescribed; do not take more than recommended. Your prescriber may recommend a special diet. Do not increase calcium intake without consulting prescriber. Avoid magnesium supplements or magnesium-containing antacids. You may experience nausea, vomiting, or metallic taste (frequent small meals, frequent mouth care, or sucking hard candy may help); hypotension (use caution when rising from sitting or lying position or when climbing stairs or bending over). Report chest pain or palpitations; acute headache, dizziness, or feeling of weakness; unresolved nausea or vomiting; persistent metallic taste; unrelieved muscle or bone pain; or CNS irritability.

Monitor symptoms of hypercalcemia (weakness, fatigue, somnolence, headache, anorexia, dry mouth, metallic taste, nausea, vomiting, cramps, diarrhea, muscle pain, bone pain, and irritability)

Capsule (Hytakerol®): 0.125 mg

Solution:

Oral Concentrate (DHT™): 0.2 mg/mL (30 mL)

Oral, in oil (Hytakerol®): 0.25 mg/mL (15 mL)

Tablet (DHT™): 0.125 mg, 0.2 mg, 0.4 mg

Letsou AP and Price LS, "Health Aging and Nutrition: An Overview," Clin Geriatr Med, 1987, 3(2):253-60.

Myrianthopoulos M, "Dietary Treatment of Hyperlipidemia in the Elderly," Clin Geriatr Med, 1987, 3(2):343-59.

Riggs BL and Melton LJ, "The Prevention and Treatment of Osteoporosis," N Engl J Med, 1992, 327(9):620-7.