Colitrol

Indications

Colitrol is recommended for the treatment of:

• Post-Menopausal Osteoporosis
• Renal Osteodystrophy
• Postsurgical Hypoparathyroidism
• Idiopathic Hypoparathyroidism
• Pseudohypoparathyroidism
• Secondary Hyperparathyroidism in patients with moderate to severe chronic renal failure (pre-dialysis)
• Vitamin D Dependent Rickets

Pharmacology

Calcitriol, a crucial active metabolite of vitamin D3, is produced in the kidneys from 25-hydroxycholecalciferol. It enhances intestinal calcium absorption and regulates bone mineralization, playing a vital role in calcium homeostasis by stimulating osteoblastic activity in the skeleton.

Dosage & Administration

The optimal daily dosage of Calcitriol must be individualized based on serum calcium levels.

• Post-Menopausal Osteoporosis: 0.25 mcg twice daily.
• Renal Osteodystrophy (dialysis patients): Initial dose of 0.25 mcg; for patients with normal or slightly reduced calcium levels, 0.25 mcg every other day may suffice.
• Hypoparathyroidism and Rickets: Start with 0.25 mcg/day in the morning. If no response is seen within 2-4 weeks, adjust the dosage accordingly.
• IV Calcitriol: Initial doses range from 1 mcg (0.02 mcg/kg) to 2 mcg, administered three times a week, with adjustments made based on response.

Consult your healthcare provider for specific dosing recommendations.

Interactions

Avoid concomitant use with thiazide diuretics due to increased risk of hypercalcemia. Caution is advised with digitalis, as hypercalcemia may induce cardiac arrhythmias. Magnesium-containing medications may lead to hypermagnesemia.

Contraindications

Colitrol is contraindicated in patients with known hypersensitivity to its components and in conditions associated with hypercalcemia.

Side Effects

Initial side effects may include weakness, headache, nausea, vomiting, and dry mouth. More severe reactions can include polyuria, weight loss, conjunctivitis, hypertension, and in rare cases, psychosis. Mild pain at the injection site may occur.

Pregnancy & Lactation

Calcitriol is not known to be teratogenic in humans but should only be used during pregnancy if the benefits outweigh potential risks. Breastfeeding is possible while taking Calcitriol, but calcium levels should be monitored.

Precautions & Warnings

Excessive doses can lead to hypercalcemia and hypercalciuria. Caution is required in patients taking digitalis. Discontinuation should be gradual to avoid rebound effects, and vitamin D should not be administered concurrently.

Special Populations

• For Secondary Hyperparathyroidism:
  • Adults and children 3 years and older: Initial dosage is 0.25 mcg/day, adjustable to 0.5 mcg/day.
  • Children under 3 years: 10 to 15 ng/kg/day.
• Elderly: No dosage adjustments needed.

Overdose Effects

Excessive use of Colitrol can cause hypercalcemia and hyperphosphatemia. Immediate discontinuation of therapy is necessary, along with dietary adjustments and cessation of calcium supplements.

Therapeutic Class

Vitamin for bone formation, specifically Vitamin D preparations.

Storage Conditions

Store in a dry place away from light and heat. Keep out of reach of children.