Calcitriol is licensed for the treatment of postmenopausal osteoporosis.
- is the active form of vitamin D and is approved for the treatment of established postmenopausal osteoporosis in a dose of 0.25µg twice daily.
- acts mainly by inhibiting bone resorption
- has been shown to reduce vertebral fracture risk in postmenopausal women with osteoporosis but effects on non-vertebral and hip fractures have not been established
- contraindicated in patients with hypercalcaemia and because it may cause hypercalcaemia and/or hypercalciuria, serum calcium and creatinine levels should be monitored at 1, 3 and 6 months after starting treatment and at 6 monthly intervals thereafter
Note that all patients receiving pharmacological doses of vitamin D should have the plasma-calcium concentration checked at intervals (initially weekly) and whenever nausea or vomiting are present (2).
Reference:
- National Osteoporosis Society (2008). Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK
- Royal College of Physicians. Osteoporosis Clinical guidelines for prevention and treatment of osteoporosis. London, 1999.
- BNF 9.6.4
- Drug and Therapeutics Bulletin 1996; 34 (11):84-6.
- Sambrook P et al. A comparison of calcium, calcitriol, and calcitonin. NEJM 1993; 328: 1747-52.