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(1 alpha, 3 beta, 5Z,7E) - 9,10-Sekokholesta-5,7,10 (19) - a triene-1,3-diol
Alfakaltsidol – analog of vitamin D which is actively used as an additive to food and a forage of poultry for completion of reserves of vitamin. Means is entered in the list of vital and essential drugs.
Medicine is synthesized in the form of white or colourless crystals which are practically not dissolved in water, but easily soluble in ethanol, will slowly be dissolved in vegetable oil. This chemical compound is not steady and decays under the influence of ultra-violet treatment and air. The molar mass of substance = 400,6 grams on mol.
Regulating calcium - a phosphorus exchange.
Pharmacodynamics and pharmacokinetics
Medicine carries out an important role in processes of maintenance of a homeostasis of a phosphoric and calcic exchange. Alfakaltsidol stimulates active absorption of phosphates and calcium from gleams of a small bowel, increases calcium reabsorption degree in renal tubules. Drug increases intensity of a mineralization of a bone tissue, reduces degree of osteomalacy and level of parathyroid hormone. Means interferes with rickets.
This chemical compound reduces the frequency of the changes resulting from the shift of calcic balance at calcic malabsorption. At the patient coordination of movements improves, there pass painful feelings in bones and muscles.
After medicine reception the effect of tablets develops within 6 hours, and about 2 days last. Alfakaltsidol in a small intestine is soaked up. The maximum concentration of drug in plasma is observed in 8-18 hours. The elimination half-life makes about 3 hours of blood. The metabolism proceeds in a liver where the active metabolite 1,25-digidroksikolekaltsiferol is formed, to a lesser extent substance is metabolized in a bone tissue. Metabolites it is removed with bile and urine.
Thanks to the fact that the metabolism of means does not occur in kidneys it is possible to appoint it at various degrees of a renal failure.
Indications to use
Medicine is appointed:
- as a prophylactic at hypo - or avitaminosis of D;
- to patients with osteomalacy, an osteopathy, osteoporosis;
- at unbalanced and defective food;
- sick hypoparathyrosis with a hypocalcemia;
- at malabsorption and insufficient insolation of vitamins;
- to patients about vitamin D-resistant rickets;
- to alcoholics;
- at cirrhosis or a liver failure, as a part of complex therapy;
- sick syndrome of Fankoni;
- at mechanical jaundice;
- if some diseases of a gastrointestinal tract break processes of digestion of vitamin D (persistent diarrhea, an illness Krone, a gluten enetropatiya, tropical to a spr);
- at fast weight loss;
- to pregnant women, in particular at polycarpous pregnancy, dependence on nicotine or some drugs;
- at insufficient insolation of newborn children on breastfeeding.
Drug is contraindicated to reception:
- to patients with a hypercalcemia;
- at an allergy to active ingredient;
- the patient with a renal osteodystrophy with a hyperphosphatemia;
- at a hypervitaminosis of D.
Extra care needs to be observed (treatment is carried out under control and according to the recommendation of the doctor):
- at atherosclerosis;
- to patients with a pulmonary tuberculosis in an active form;
- the patient with a sarcoidosis and other granulomatoses;
- at heart failure;
- at chronic diseases of kidneys;
- if at the patient in the anamnesis it was observed nefrourolitiaz;
- at a hyperphosphatemia;
- to elderly patients, in order to avoid development of atherosclerosis;
- to children.
Usually medicine does not cause any side reactions.
Can be shown:
- anorexia, nausea, unpleasant feelings in epigastric area, vomiting, dryness of a mucous membrane of an oral cavity, a lock;
- increased fatigue, drowsiness, weakness, dizziness;
- enanthesis, allergic itch.
- growth of activity of enzymes of a liver, ALT, nuclear heating plant;
- increase of the LPVP level in a blood plasma;
- hyperphosphatemia (develops against disturbances in work of kidneys).
Alfakaltsidol, application instruction (Way and dosage)
Drug is appointed inside or intravenously.
Treatment is begun with small doses, once a week carry out analyses, determine the level of calcium and phosphorus in blood.
Inside. The recommended daily dosage – 1 mkg. At good tolerance it can be raised on 0,25-0,5 mkg a day. For children correction of a dosage, depending on the weight and age can be required. To children of 3 flyings appoint from 0,01 to 0,08 mkg to one kg of weight.
Duration of treatment depends on an illness, portability of drug and efficiency of treatment. In certain cases medicine is appointed for life.
Intravenously drug is used at the end of a hemodialysis session in the form of a bolus. The injection is carried out to the returnable line of the device. The one-time dosage makes from 1 to 6 mkg. The maximum number of Alfakaltsidol which the patient can enter within a week – 12 mkg.
At systematic reception of big dosages of drug the hypervitaminosis of D can develop.
Hypercalcemia symptoms at early stages: a lock or diarrhea, ostealgias, drowsiness, muscle pains, smack of metal in a mouth, a polydipsia, lack of appetite, increased fatigue, a nocturia.
Symptoms of a hypervitaminosis of D at later stages: muddy urine, painful feelings in bones, a leykotsitonuriya, the increased body temperature, conjunctivitis, ectopic calcification, growth of the ABP, decrease in sexual desire, a photosensitivity, pancreatitis, a rhinorrhea, psychoses, loss of weight.
Symptoms of chronic intoxication vitamin D are: raised by the ABP, calcification of kidneys, lungs, blood vessels, heart failure, up to a lethal outcome, disturbance of normal process of growth at small children.
As therapy medicine is cancelled. If acute overdose happened less than 2 hours ago, then it is possible to wash out a stomach, to give to the victim mineral oil. The maintenance therapy, introduction of infusion saline solutions, loopback diuretics, biphosphonates, glucocorticosteroids, a calcitonin is also shown. The hemodialysis is effective.
Phenytoinum, barbiturates, antiepileptic means reduce Alfakaltsidol's efficiency.
The drug combination to the means causing induction of microsomal enzymes of a liver leads to decrease in efficiency of drug. It is recommended to increase Alfakaltsidol's dosage.
The concomitant use of means and drugs of a foxglove increases probability of development of cardiac arrhythmia. At a combination to calcium and drugs of calcium, thiazide diuretics – there is a risk of a hypercalcemia.
Antacids and purgatives increase probability of development of a gipermagniyemiya.
At the combined administration of drug with mineral oils, kolestipoly, Colestyraminum, antacids, albumine or sukralfaty its absorbing capacity decreases and process of evacuation of an organism accelerates.
Medicine is not taken together with kolekaltsiferoly and its derivatives.
Carrying out a laksativodializ against treatment by Alfakaltsidol increases probability of development of a gipermagniyemiya and giperalyuminemiya.
Terms of sale
The recipe is necessary.
During treatment drug recommends to control periodically the level of calcium and phosphates in blood. At the initial stages of treatment analyses spend each 3-4 days, then after stabilization of a condition of the patient – each 3-5 weeks. Once in 2 months is recommended to determine calcium level in urine, the ShchF level.
If before administration of drug the chronic renal failure was found in the patient, it is necessary to correct a hyperphosphatemia. When the ShchF level in a blood plasma was normalized, the dosage is recommended to be lowered.
With extra care appoint intravenous administration of medicine to newborn premature children.
The hypercalcemia arises at diseases of kidneys, high dosages of medicine and the raised extent of demineralization. Therefore after normalization of the ShchF level in blood serum or at emergence of biochemical signs of normalization of structure of a bone it is necessary to lower Alfakaltsidol's dosage.
Patients with a renal osteodystrophy need to appoint medicine in a combination with the drugs connecting phosphates to prevent development of a hyperphosphatemia.
If during treatment the patient had a hypercalcuria, then therapy is stopped and after a while appoint Alfakaltsidol in smaller doses. Sensitivity degree to vitamin D is strictly individual.
For prevention of a hypovitaminosis it is recommended it is balanced to eat.
Unlike natural vitamin D, this drug does not undergo reaction of a metabolism in kidneys that allows to appoint medicine to patients with a renal failure.
There are messages that means was rather effective during treatment of the secondary hyper parathyroidism which resulted from a renal failure.
At children who during a long span accept this substance the probability of a growth inhibition increases. During treatment it is recommended to correct a dosage according to the weight and age of the child.
Elderly patients have an increased need for vitamin D.
At pregnancy and a lactation
To pregnant women medicine is appointed by the attending physician, in a case when the expected advantage is higher, than potential risk for health of the woman and the child.
It is impossible to appoint means during feeding a breast.
Synonyms: Alphadale, Oksidevit, Etalfa, Alf D3-Teva, Van-Alpha, Oksidevita of a capsule.
In a combination with calcium carbonate substance is in the drug Alfadol-Sa. Also means is a part of tablets Tevabon in combination with alendronovy acid.
About Alfakaltsidol's drugs good. Medicine is often appointed to small children, to elderly patients, side reactions are shown seldom. At competent selection of a necessary dosage according to recommendations of the doctor medicine is rather effectively and well transferred.
The price of Alfakaltsidol where to buy
The cost of capsules Alpha D3-Teva makes about 190-300 rubles, a dosage of 0,24 mkg for 30 pieces.
Section: Active ingredients
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