Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Alfacip
Active ingredient: Alfacalcidol
Available dosage forms: 1 mcg
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The period frailty is growing more and much more popular in geriatric medicine. Researchers think that factors like age as well as physical health must be taken under account when deciding the RDA. Mortality was positively connected with frailty. A number of studies didn’t confirm an association between vitamin D status as well as physical performances. Most these criteria are associated with locomotion as well as physical strength.
IPD meta-analysis is just a particular sort of systematic review. Relevant health economic evidence for recommendations are found within the particular chapters of the total form of the original guideline document. These topics are suggested. The information readers should know. By supplying access to this patient information, it isn’t the intention of NGC to present specific medical tips for particular patients. Similar types of words (for instance, `Do not offer’) are used while the GDG is confident an intervention won’t be of benefit for the majority of patients.
The ratings for every single component were summed to get a total assessment for every outcome. The reasons or criteria taken for downgrading were specified within the footnotes. These criteria are detailed within the full variant of the guideline. Here is the present release of the guideline. Further research is is more than likely to have a vital effect on confidence within the estimate of effect and could alter the estimate. Further research is extremely possible to have a crucial effect on confidence within the estimate of effect and will probably change the estimate.
Don’t offer you a mix of reninangiotensin system antagonists to folks with CKD. If there’s any issue, you can not operate properly. Don’t utilize urine microscopy to verify a positive outcome. If uncertain, seek help from a community renal support.
The authors declare that there’s no conflict of interests about the publication of the paper. Finally, we didn’t incorporate the totality of studies meeting the aforementioned criteria, so as to prevent redundancies. No papers following this date were considered.
Calcium is considered among the important minerals. There are lots of side effects of the compound, it can lead to diarrhea and also lowers the degree of magnesium and potassium within the blood. Folic acid is utilized by pregnant women to prevent complicacies when pregnant. The deficiency of said compound contributes to anemic conditions.
From here, there are just two strategies to go. It didn’t comment further. This consequently lessens the risk linked to heart diseases. These come in assorted sets and packs.
Dioctyl Sodium Sulfosuccinate is utilized for remedying constipation when pregnant. Anyone having low iron level within the blood can utilize these capsules. Additionally, It keeps the teeth and also the immune system healthy.
It is a type of vitamin D. This a form of vitamin B. This compound is, in addition, effectual in lowering the homocysteine levels. This compound is utilized for healing flatulence and colic. The deficiency might bring about various diseases. This compound aids in formation of RBC.
Folks who are already experiencing kidney problems should consult their physician prior to taking calcium supplements. In addition, It can interfere with the entire body’s capacity to absorb selected antibiotics like etc.. There are lots of side effects linked to using of capsules containing Ferrous Furamate. Don’t adjust your dosage sans the approval of your own health care provider.
A very low vitamin D status is consistently connected with frailty. Finally, a minimal vitamin D status is consistently linked to the frail phenotype. Vitamin D not just is associated with frailty but in addition seems to be related to an elevated risk to develop frailty as time passes in women. Mechanisms resulting in vitamin D nongenomic effects aren’t definitely elucidated.
The right dosage and prescription commonly are based on the patient along with the condition being treated. Side effects may also occur because of adverse drug interactions. An overdose could also create a person susceptible to heart ailments or superior blood pressure. For example, it might increase the repercussions of digoxin, which is really a drug which is used to take care of cardiac arrhythmia or congestive heart failure.
Adults afflicted by this deficiency tend toward osteomalacia, which really is a condition that’s characterized by the weakening of the muscles and bones. This may exert a hypertensive outcome on the heart muscle, which then increases the threat of stroke as well as heart attack. This deficiency may also hamper the production of insulin within the body, thereby earning a person prone to type 2 diabetes.
Rickets is just a disease that’s typically characterized by bone deformities. There was certainly no difference between the therapy and also the control groups. A daily dose of 1000UI seems to be sufficient to acquire vital improvements. It could result in pain within the bones, muscles, and joints.
If you’re taking calcium supplements, it will always be advisable to seek advice from a doctor for its proper dosage. Keep away from self medication as excess calcium inside your body might result in many health complications. If there’s too much calcium in your blood, it may cause a condition called hypercalcemia. It can help to build up the vitamin D absorption within the body. Too much calcium within the blood (over 2500 mg) might result in calcium toxicity.
Active – active substance / start: alfacalcidol
Alfadol; Alpha D3 (Alpha D3 Teva); alfacalcidol; Van – alpha; Oksivitamin D3; Oksidevit; Oksidevita capsule; Oksiholekaltsiferol; Etalfa.
Alfacalcidol – the regulator of calcium and phosphorus metabolism, a precursor of the active metabolite of vitamin D3. It is used in diseases caused by violation of phosphorus – calcium metabolism: Osteoporosis, bone disease, hypoparathyroidism, rickets, osteomalacia, Fanconi syndrome, hypocalcemia, hypophosphatemia .
Active – active substance:
Alfacalcidol / Alfacalcidol.
The solution – drops for oral administration.
The solution for injection.
Properties / Action:
Alfacalcidol – Drugs affecting the metabolism (the regulator of calcium and phosphorus metabolism). It is a precursor of the active metabolite of vitamin D3. Restores a positive calcium balance in the treatment of calcium malabsorption:
In exchange application of the drug observed decrease in bone and muscle pain associated with the violation of phosphorus – calcium metabolism, improve the coordination of movements.
The drug comes quickly, and the presence of a large number of formulations with different contents of active substance can accurately adjust the dose that reduces the risk of prolonged hypercalcemia.
It has a more pronounced antirahiticheskoy active than ergocalciferol.
After oral alfacalcidol is rapidly absorbed from the gastrointestinal tract. Bioavailability is approximately 100%. The time to maximum concentration of drug in plasma is from 8 to 18 hours.
In the liver, alfacalcidol is metabolized in the major active metabolite of vitamin D3 – calcitriol (1alpha, 25 – dihydroxyvitamin D3). T1 / 2 of 1.25 – dihydroxyvitamin D3 is about 35 h A smaller portion of the drug is metabolized in the bone.. In contrast to the natural vitamin D3 the biotransformation of the drug does not occur in the kidneys, it can be used in patients with renal disease patients.
Diseases caused by violation of phosphorus – calcium metabolism:
Dosage and administration:
The drug is taken by mouth or injected into / in.
adults – initial dose of 1 mg / day; maintenance dose – 0.25 – 1 mg / day, children – 0.25 mg / day.
Initiate therapy with the minimum recommended dose of said controlling 1 weekly levels of calcium and phosphorus in the blood plasma. Dose can be increased to 0.5 or 0.25 mg / day every 2 – 4 weeks to 2 (in rare cases higher) mg / day to stabilize the biochemical parameters. Upon reaching the lowest effective doses it is recommended to control the calcium level in the blood plasma every 3 – 5 weeks.
The course duration is determined by the physician individulno and depends on the nature of the disease and the effectiveness suffers. In some cases, the drug is used during the whole life.
Adults with rickets and osteomalacia . due to exogenous vitamin D insufficiency, gastrointestinal diseases or long-term anticonvulsant therapy, the drug is prescribed in a dose of 1 – 3 g / day.
When hypoparathyroidism daily dose of 2 – 4 mg.
In osteodystrophy in chronic renal failure daily dose of 2 g.
In the Fanconi syndrome and renal acidosis the drug is administered in a daily dose of 2 – 6 mg.
In hypophosphatemic rickets and osteomalacia daily dose is 4 – 20 micrograms.
In postmenopausal, senile, steroid and other forms of osteoporosis daily dose is 0.5 – 1 mg.
Services with a body weight less than 20 kg of the drug is prescribed to 0.01 – 0.05 mg / kg / day for children weighing 20 kg and above 1.0 mg / day (except in cases renal osteodystrophy). In rickets typically used to 0.1 mg a day every day for 10 days. Spend 3 courses with 2 – week break in between.
In renal osteodystrophy in children , the dose is 0.04 – 0.08 mg / kg / day.
Alfacalcidol can be administered intravenously after hemodialysis. The starting dose for adults is 1 mg per 1 dialysis. The maximum dose – 6 micrograms per dialysis and no more than 12 micrograms per a week. The drug is administered at the end of each dialysis session into the return line of the apparatus as close as possible to the patient to prevent possible suction alfacalcidol plastic. Dose
changed in accordance with the dynamics of biochemical parameters in order to avoid hypercalcemia. Definition of indicators includes calcium level measurement in serum alkaline phosphatase, parathyroid hormone, the amount of calcium excreted in the urine; also conduct radiographic and histological investigations. With the development of hypercalcemia use of the drug should be discontinued immediately until such time as the level of calcium in the blood serum is not normal (usually within a week). Then, the drug is prescribed once again, reducing the dose by half.
Patients with bone lesions significantly expressed (in contrast to patients with renal osteodystrophy) can tolerate higher doses without causing hypercalcemia. Lack of rapid increase of calcium in the serum of patients with osteomalacia not necessarily mean that the dose must be increased, because Calcium can penetrate the demineralized bone tissue due to the increased absorption in the intestine.
Symptoms: weakness, lethargy, dizziness, headache; nausea, dry mouth, constipation, diarrhea, heartburn, vomiting, epigastric pain, abdominal pain, bone pain, itching, tachycardia.
Treatment: should stop taking the drug. In the early stages of an acute overdose may have a positive effect of gastric lavage and / or administration of mineral oil (which reduces absorption and increases excretion of the drug in the feces).
In severe cases, used in / with the introduction of isotonic sodium chloride solution. appointment of loop diuretics, corticosteroids.
atherosclerosis, liver and kidney function.
Use during pregnancy and lactation:
During pregnancy alfacalcidol appointed only if absolutely indicated, if the expected benefits exceed the risks.
The drug is contraindicated during lactation, breast-feeding. If necessary, the appointment during lactation should decide the issue of termination of breastfeeding.
Effect on the metabolism: seldom – hypercalcemia; very rarely – a slight increase in HDL (high density lipoprotein) plasma. In patients with severe renal impairment may develop hyperphosphatemia.
On the part of the digestive tract and liver: anorexia, nausea, vomiting, dry mouth, metallic taste in the mouth, heartburn, abdominal pain, discomfort in epigastrium, constipation, diarrhea, weight reduction a body; rarely – a slight increase in ALT, AST in plasma.
From the CNS: rare – weakness, fatigue, headache, dizziness, drowsiness, dysphoria, photophobia.
Cardio – vascular system: rare – tachycardia, hypertension, arrhythmia.
Allergic reactions: rare – skin rash, itching.
From the bone – muscular system: moderate pain in the muscles, bones, joints.
Special instructions and precautions:
With care prescribe a drug to patients who are prone to hypercalcemia, particularly in patients with urolithiasis.
Like vitamin D, alfacalcidol in doses exceeding the physiological need, can have toxic effects. Drug toxicity of vitamin D, but unlike him, does not accumulate in the body, and undergoes rapid catabolism and excretion.
During the period of the drug should be regularly (at least 1 time in 3 months) to control the level of calcium and phosphorus in the blood plasma and urine, as well as the activity of alkaline phosphatase (if CKD requires weekly monitoring). More frequent monitoring is recommended at an early stage of treatment (especially when initially high content of calcium in blood serum).
It is necessary to observe the development of therapeutic effect and to adjust the dose of alfacalcidol in order to avoid the development of hypercalcemia and hypercalciuria, if necessary. The risk of hypercalcemia depends on the degree of demineralization, kidney and dose.
hypercalcemia or hypercalciuria can be adjusted by the withdrawal of the drug and reduce the intake of calcium to normalize the calcium concentration in the blood plasma. Typically, this period is one week. Then therapy can be continued, since the latter half of the applied dose.
If there is biochemical evidence of normalization of bone structure (normalization of alkaline phosphatase in the blood plasma) must be a corresponding reduction in the dose of alfacalcidol, thus avoiding the development of hypercalcemia.
Avoid prolonged hypercalcemia, particularly in chronic renal failure.
Patients with renal osteodystrophy may be administered in combination with drugs binding phosphates to prevent hyperphosphatemia.
In osteoporosis drug can be used in combination with estrogens and inhibitors of bone resorption different groups (antiresorptive drugs).
The drug in the form of a solution – drops for oral administration can not be diluted.
Alfacalcidol in the form of a solution for injection is used with caution in preterm neonates.
With the simultaneous use of digitalis drugs increases the risk of arrhythmia.
When concomitant administration with barbiturates, anticonvulsants and other drugs, activating enzymes of microsomal oxidation in the liver may reduce the effectiveness of alfacalcidol – you need to use a higher dose of alfacalcidol. Suction
alfacalcidol reduced by combining it with mineral oil, mineral oil (for a long time), colestyramine, colestipol, sucralfate ohm, antacids, drugs and by albumin.
When applied simultaneously with antacids alfacalcidol increased risk of gipermagniemii.
Co-administration of calcium preparations, thiazide diuretics increases the risk of hypercalcemia.
In the alfacalcidol therapy should not be prescribed vitamin D and its derivatives of the – of the possible additive interaction and increase the risk of hypercalcemia.
The drug is in the form of capsules should be stored at room temperature (not above 25 ° C).
The drug in the form of a solution – drops of oral or injectable solution at a temperature of 8 ° to 15 ° C, protected from light.
Keep out of the reach of children.