Concurrent digitalis preparation may precipitate cardiacarrhythmias.

Thiazide diuretics cause hypercalcaemia by increasing renal tubular reabsorption of calcium and thus increase the hypercalcaemic response to alfacalcidol.

Phenobarbitone and other enzymes-inducers may reduce activation of alfacalcidol into calcitriol.

Prolonged use of mineral oil may reduce absorption.

Cholestyramine, cholestipol, sucralfate or large amounts of aluminium based antacids may also reduce absorption.

Hypermagnesiumia may occur with concomittant use of magnesium based antacids or laxatives in those on chronic renal dialysis.

Osteoporosis

Hypercalcaemia.In case of renal impairment,hyperphosphataemia.

In hypercalcaemic patients possibility of calcium influx from the dialysate should be considered.

Increased risks of renal stones.

Hypercalcemia,hyperphosphataemia(except when occuring with hypothyroidism), hypermagnesiumia,

Vit D toxicity or known hypersens effects of Vit D.

Special precautions:

Pregnancy and lactation,

renal impairment, elderly.

Monitor serum levels in patients with renal failure.

Caution in hypercalcuria esp in those with history of renal calculli.

Indication

Osteoporosis

Dosage

Initially 0.5mg daily adjusted according to response

Children- 0.04mg/kg daily

Take with food

Take with food