Alphacad

Alphacad is an active metabolite of Vitamin D, which performs important functions in regulation of the calcium balance and the bone metabolism. (Hypocalcemia; Osteodystrophy; secondary hyperparathyroidism;)

Initial Dose: Adults and Children >20 kg body weight: 1 mcg daily. Children <20 kg body weight: 0.05 mcg/kg/day. Neonates: 0.1 mcg/kg/day.

It is important to adjust dosage according to the biochemical responses and to avoid hypercalcaemia. Indices of response include levels of serum calcium, alkaline phosphatase, parathyroid hormone, urinary calcium excretion as well as radiographic and histological investigations. Patients with marked bone disease (other than those with renal failure) may tolerate higher doses without developing hypercalcaemia. However, failure of the serum calcium to rise promptly in osteomalacic patients does not necessarily mean that a higher dose is required, since calcium from increased intestinal calcium absorption may be incorporated into demineralized bone.

Most patients will respond to doses between 1 and 3 mcg daily.

The dose requirements generally decrease in patients with bone disease when there is biochemical or radiographic evidence of bone healing and in hypoparathyroid patients after normal serum calcium levels have been obtained. Maintenance doses are generally in the range of 0.25-2 mcg daily.

Alphacad can be given as an IV injection following each hemodialysis. The injection should be administered into the return line from the hemodialysis machine at the end of each dialysis. The initial dose for adults is 1 mcg/dialysis. The maximum dose recommended is 6 mcg/dialysis and not more than 12 mcg/week.

Patients concurrently taking barbiturates or other anticonvulsants may need larger doses of Alphacad to produce the desired effect.

Hypersensitivity to 1α-hydroxyvitamin D3, vitamin D or to any of the analogues and derivatives of Alphacad.

Alphacad is contraindicated when there is a biochemical evidence of hypercalcaemia. Likewise, the drug is contraindicated when there is any evidence of vitamin D overdosage.

Alphacad is used to treat softening and deformity of the bones due to lack of calcium (rickets or osteomalacia), low levels of calcium in the blood of newborn babies and changes in bone caused by kidney failure (osteodystrophy).

Patients taking barbiturates or anticonvulsants may require larger doses of Alphacad to produce the desired effect.

Incompatibilities: Alphacad should not be used concomitantly with other vitamin D products or derivates.

Anorexia, nausea, vomiting, diarrhoea, lassitude, polyuria, sweating, headache, thirst, vertigo, pruritus, rash, urticaria. Hypercalcaemia, hypercalciuria and ectopic calcification. In case of renal impairment, hyperphosphataemia. In hypercalcaemic dialysis patients, possibility of calcium influx from the dialysate should be considered.

Alphacad is an active metabolite of Vitamin D, which performs important functions in regulation of the calcium balance and the bone metabolism. Alphacad is Vitamin D-hormone analog which is activated by the enzyme 25-hydroxylase in the liver for systemic and in osteoblasts for local D-hormone actions. It possesses a unique pattern of pleiotropic effects on, e.g. gut, bone, pararthyroids, muscle and brain. Alphacad is superior to plain vitamin D (cholecalciferol) because the final kidney activation of the latter is regulated by a negative feedback mechanism. (PMID:17438884,17668216)