Calcitriol is the active form of vitamin D. It has many functions, including absorbing calcium from food into the bloodstream and transporting calcium into bones. Available only with a prescription, synthetic calcitriol helps raise low calcium levels and strengthen weakened bones in people with chronic kidney disease or underactive parathyroid. A topical version treats the symptoms of plaque psoriasis. High calcium is the most common side effect, affecting 1 out of 3 patients taking calcitriol. Immediately inform the prescriber if any signs of high calcium are experienced when taking calcitriol.
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Calcitriol overview
BRAND NAMES:
Rocaltrol, Vectical
Generic Names:
Calcitriol
Uses:
Oral calcitriol treats low calcium due to chronic kidney disease or underactive thyroid.
Topical calcitriol treats plaque psoriasis.
Therapeutic Classes:
Vitamin D analogue, topical antipsoriasis agent
Forms:
Capsule, oral solution, injection, topical ointment
How it’s taken:
By mouth, injection, on the skin
What is Calcitriol used for?
Healthcare providers use oral and injected calcitriol to treat low calcium and weakened bones in people with chronic kidney disease. They also use it to treat low calcium levels caused by an underactive parathyroid gland. Topical calcitriol is used to manage mild to moderate plaque psoriasis symptoms.
What form(s) does Calcitriol come in
Capsule
0.25 mcg
0.5 mcg
Oral solution
1 mcg/mL
Injection
1 mcg/gm
Ointment
3 mcg/g
What are common Calcitriol doses?
For low calcium and bone disease due to chronic kidney disease requiring dialysis:
In adults: 0.25–1 mcg taken by mouth daily OR 1–2 mcg intravenous injection every two days
In adolescents: 0.5–1.5 mcg intravenous injection every two days
For low calcium and bone disease due to pre-dialysis chronic kidney disease:
In adults and children 3 years of age and older: 0.25–1 mcg taken by mouth daily
In children 1 month to 2 years old: 0.01–0.015 mcg/kg (maximum: 5 mcg/day) taken by mouth daily
For low calcium caused by an underactive parathyroid gland:
In adults and children 6 years of age and older: 0.5–2 mcg taken by mouth daily
In children 1–5 years old: 0.25–0.75 mcg taken by mouth daily
For plaque psoriasis:
In adults and children 7 years of age and older: Apply to the affected skin twice daily to a maximum dose of 200 grams weekly
In children 2–6 years old: Apply to the affected skin twice daily to a maximum dose of 100 grams weekly
Common Calcitriol prescriptions
Calcitriol
1ml of 1mcg/ml ampuleCalcitriol
15ml of 1mcg/ml bottleCalcitriol
0.25mcg capsuleCalcitriol
0.5mcg capsuleCalcitriol
100gm of 3mcg/gm tubeCalcitriol
100gm of 3mcg/gm tube of ointmentCalcitriol
1ml of 1mcg/ml vial
How to take Calcitriol
Follow all the prescriber’s instructions when administering calcitriol.
Do not take more calcitriol than prescribed or take doses more often than instructed.
How to take oral calcitriol:
Calcitriol capsules and liquid can be taken with or without food.
Swallow the capsule whole with a glass of water.
Measure the oral solution with the oral syringe or calibrated medicine cup that comes with the medicine.
Store calcitriol capsules or liquid at room temperature protected from light.
How to administer topical calcitriol doses:
Use calcitriol ointment only on the skin. Do not get it in your mouth, eyes, or vagina.
Apply two doses daily to the affected skin.
Use only enough ointment to cover the affected skin.
After spreading the ointment on the skin, gently and completely rub it into the skin.
Do not apply a bandage or other air- or water-tight dressing to the treated skin.
Wash your hands when finished.
Store calcitriol ointment at room temperature. Do not refrigerate or freeze.
What to do if you miss a dose of Calcitriol
Take a dose as soon as you remember.
If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose.
Calcitriol contraindications
This medicine is not right for everyone.
Do not use it if you have:
High calcium levels (hypercalcemia)
Vitamin D poisoning
Known allergies to calcitriol or other vitamin D medications or supplements
Calcitriol warnings
Before starting calcitriol, tell the prescribing healthcare professional if you are pregnant, breastfeeding, or have:
High calcium
High phosphorus
Heart disease
Do not use more calcitriol than instructed. Too much of this medicine may cause a dangerous amount of calcium to build up in your body.
If you are not on dialysis, drink extra liquids to prevent dehydration.
If using topical calcitriol, avoid sunlight. The UV radiation can break down the calcitriol and make it less effective.
Women who are breastfeeding should not apply topical calcitriol to the nipple or areola.
Report any adverse effects to the prescribing healthcare provider.
Calcitriol interactions
To avoid possible drug interactions, tell the prescribing healthcare provider about all drugs and supplements being taken, particularly:
Drugs that make you pee (diuretics), especially thiazide diuretics
Vitamin D supplements or medications
Calcium supplements or antacids
Magnesium supplements or antacids
Drugs called phosphate binders
Cholestyramine, digitalis, ketoconazole, phenobarbital, phenytoin
When taking oral or topical calcitriol, do not take any of the following until consulting with the prescriber:
Multivitamins
Vitamin D supplements
Calcium supplements
Magnesium supplements
Phosphate supplements
Antacids
Calcitriol side effects
Serious Side Effects
Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:
Nausea, vomiting, stomach pain, loss of appetite, constipation
Bone pain, joint pain
Tiredness, fatigue, feeling sick
Back or flank pain, excessive urination, excessive thirst, cloudy or foaming urine
Listlessness, depression, irritability, problems thinking, memory problems
Irregular heartbeat
Muscle weakness, confusion, psychosis, coma
Allergic reaction: Itchy skin, rash, hives, swelling in your face, lips, or mouth, throat tightness, chest tightness, trouble swallowing, trouble breathing
Less serious side effects
Headache
Skin discomfort (ointment)
Sources:
Calcitriol, StatPearls
Calcitriol injection prescribing information, DailyMed (NIH National Library of Medicine)
Calcitriol solution prescribing information, DailyMed (NIH National Library of Medicine)
Rocaltol calcitriol capsule prescribing information, DailyMed (NIH National Library of Medicine)
Rocaltol drug summary, Prescriber’s Digital Reference (PDR)
Vectical calcitriol ointment prescribing information, DailyMed (NIH National Library of Medicine)
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