Formulary
Calcitriol: Indications, Dosing, Side Effects and Interactions
Calcitriol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Calcitriol: Indications, Dosing, Side Effects and Interactions
Calcitriol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Mild to moderate plaque psoriasis**
- **Adult** (To The Skin): Apply twice daily, not more than 35% of body surface to be treated daily; maximum 30 g per day.
**Renal osteodystrophy**
- **Adult** (By Mouth): 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** (By Mouth): 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** (By Mouth): 250 nanograms twice daily.
**Mild to moderate plaque psoriasis for calcitriol**
- **Child 12-17 years** (To the skin): Apply twice daily, not more than 35% of body surface to be treated daily; maximum 30 g per day.
**Vitamin D dependent rickets, Hypophosphataemic rickets, Persistent hypocalcaemia due to hypoparathyroidism, Pseudo-hypoparathyroidism (limited experience) for calcitriol**
- **Child 1 month-11 years** (By mouth): Initially 15 nanograms/kg once daily (max. per dose 250 nanograms), increased in steps of 5 nanograms/kg daily (max. per dose 250 nanograms) if required, dose to be increased every 2-4 weeks.
- **Child 12-17 years** (By mouth): Initially 250 nanograms once daily, increased in steps of 5 nanograms/kg daily (max. per dose 250 nanograms) if required, dose to be increased every 2-4 weeks; usual dose 0.5-1 microgram daily.
Cautions
With topical use Erythrodermic exfoliative psoriasis (enhanced risk of hypercalcaemia); generalised pustular psoriasis (enhanced risk of hypercalcaemia)
Contraindications
D and analogues (systemic) Hypercalcaemia; metastatic calcification Contra-indications For calcitriol With topical use Do not apply under occlusion; patients with calcium metabolism disorders
Side effects
D and analogues (systemic) Common or very common Abdominal pain; headache; hypercalcaemia; hypercalciuria; nausea; skin reactions Uncommon Appetite decreased; arrhythmia; asthenia; constipation; diarrhoea; dry mouth; myalgia; vomiting; weight decreased Overdose Symptoms of overdosage include anorexia, lassitude, nausea and vomiting, diarrhoea, constipation, weight loss, polyuria, sweating, headache, thirst, vertigo, and raised concentrations of calcium and phosphate in plasma and urine. Side-effects For calcitriol Common or very common With oral use Urinary tract infection Frequency not known With oral use Abdominal pain upper; apathy; dehydration; drowsiness; fever; growth retardation; muscle weakness; paralytic ileus; polydipsia; psychiatric disorder; sensory disorder; thirst; urinary disorders Side-effects, further information Since systemic absorption might follow topical use, also consider the side-effects of systemic vitamin D and analogues.
Interactions
**Other interactions (3):**
- Silkis must be used with caution in patients receiving medications known to increase the serum calcium level, such as thiazide diuretics or medications with pharmacological effects impacted by a...
- There is no experience of the concurrent use of calcitriol and other medications for the treatment of psoriasis.
- Information on interaction of systemic medications after the use of calcitriol ointment is limited.
Pregnancy
D and analogues (systemic) High doses teratogenic in animals but therapeutic doses unlikely to be harmful. Pregnancy For calcitriol With topical use: Manufacturer advises use in restricted amounts only if clearly necessary. Monitoring in pregnancy With topical use: Monitor plasma-calcium concentration in pregnancy. M
Breast feeding
D and analogues (systemic) Caution with high doses; may cause hypercalcaemia in infant-monitor serum-calcium concentration. Breast feeding For calcitriol With topical use: Manufacturer advises avoid.
Hepatic impairment
With topical use: Manufacturer advises avoid.
Renal impairment
Manufacturer advises avoid-no information available.
Medicinal forms
Solution,Capsule,Solution,Ointment
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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