Calcitriol Suspension

Calcitriol Suspension
Usage
Calcitriol suspension is an oral liquid formulation of the active form of vitamin D (1,25-dihydroxyvitamin D₃) used to manage conditions related to calcium and phosphate imbalance. It is particularly useful in patients who require individualised dosing or have difficulty swallowing capsules.
It may be prescribed for:
• Hypocalcaemia (low blood calcium levels)
• Chronic kidney disease (CKD)–associated mineral and bone disorders
• Hypoparathyroidism
• Secondary hyperparathyroidism
• Vitamin D–related bone disorders, such as rickets or osteomalacia

Dosage
Dosage should be determined by the prescribing practitioner based on the patient’s condition, age, laboratory values, and response to treatment.
Typical dosing considerations include:
• Administered once daily or as directed
• The dose is often adjusted based on serum calcium, phosphate, and parathyroid hormone (PTH) levels
• The suspension should be shaken well before use
• May be taken with or without food
Regular monitoring is essential to ensure safe and effective dosing.

Mechanisms of Action
Calcitriol is the active form of vitamin D and plays a key role in calcium and phosphate homeostasis.
Its mechanisms include:
Increased intestinal absorption of calcium and phosphate
Calcitriol enhances absorption of calcium and phosphate from the gastrointestinal tract.
Regulation of bone metabolism
It promotes normal bone mineralisation by maintaining appropriate levels of calcium and phosphate.
Suppression of parathyroid hormone (PTH)
Calcitriol reduces elevated PTH levels, particularly in patients with chronic kidney disease.
Improved calcium balance
By increasing calcium availability, it helps correct hypocalcaemia.

Contraindications
Calcitriol should not be used in patients with:
• Hypercalcaemia (elevated blood calcium levels)
• Vitamin D toxicity
• Hypersensitivity to calcitriol or vitamin D analogues
• Conditions associated with excess calcium or phosphate levels

Precautions
Calcitriol should be used with caution in patients with:
• Renal impairment, requiring careful monitoring
• Hyperphosphataemia
• History of kidney stones
• Conditions predisposing to hypercalcaemia
Additional considerations include:
• Regular monitoring of serum calcium, phosphate, and renal function is essential
• Excessive dosing may lead to hypercalcaemia, which can cause nausea, vomiting, weakness, confusion, or cardiac arrhythmias
• Patients should avoid excessive intake of calcium supplements or vitamin D unless advised by their healthcare provider
• Dose adjustments may be required based on laboratory results
Patients should seek medical advice if they experience symptoms of high calcium levels, such as increased thirst, frequent urination, or muscle weakness.

Storage
• Store below 25°C unless otherwise directed
• Keep the suspension in a tightly closed container
• Shake well before use
• Protect from heat, moisture, and direct light
• Some formulations may require refrigeration, depending on compounding instructions
• Keep out of reach of children and pets
Patients should follow the specific storage instructions provided on the dispensing label supplied by the pharmacy.