SYMBICORT RAPIHALERª 160/4.5 mcg Price

Overview

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This medicine contains an important and useful components, as it consists of
Budesonide/Formoterolis available in the market in concentration

Name

Alfacalcidol

Precaution

Before starting **Alfacalcidol**, it is essential to consult a healthcare provider to ensure that the medication is appropriate for your condition and to establish the correct dosage. Key precautions include: - **Hypercalcemia**: Since **Alfacalcidol** increases calcium absorption, patients with **hypercalcemia** or conditions that predispose them to high calcium levels (such as **sarcoidosis**, **tuberculosis**, or certain cancers) should use this medication with caution. Regular monitoring of **serum calcium** levels is essential to avoid excessive calcium buildup, which can cause symptoms like **nausea**, **vomiting**, **weakness**, and **kidney stones**. - **Renal Impairment**: Alfacalcidol is metabolized to its active form by the **liver and kidneys**, so patients with **renal impairment** should be monitored closely. Dose adjustments may be necessary, as impaired renal function can lead to **accumulation** of the active metabolite, increasing the risk of **hypercalcemia**. - **Vitamin D Toxicity**: Long-term or excessive use of **Alfacalcidol** can lead to **vitamin D toxicity**, as it is a form of **vitamin D**. Symptoms of toxicity include **elevated calcium levels**, **bone pain**, and **calcification of soft tissues**. - **Pregnancy and Lactation**: The use of **Alfacalcidol** during pregnancy should be carefully considered. It is classified as **Category C**, meaning that it should only be used if the benefits outweigh the potential risks to the fetus. For breastfeeding mothers, consult a healthcare provider to determine if the medication can be used safely. - **Cardiovascular Health**: Alfacalcidol should be used with caution in patients with **heart disease**, as it can increase the risk of **hypercalcemia**, potentially leading to arrhythmias or **cardiac complications**.

Indication

**Alfacalcidol** is primarily used to manage and treat conditions related to calcium and vitamin D deficiencies, including: - **Renal Osteodystrophy**: It is commonly used in patients with **chronic kidney disease (CKD)** to help regulate calcium and phosphate balance, as kidney disease can impair the activation of vitamin D. **Alfacalcidol** helps in improving bone health and reducing the risk of fractures in these patients. - **Osteomalacia**: This condition involves the softening of the bones due to **vitamin D deficiency**. Alfacalcidol helps to restore normal bone mineralization. - **Rickets**: It is used to treat **rickets** in children, a condition caused by **vitamin D deficiency** that leads to weakened bones and skeletal deformities. - **Hypoparathyroidism**: Alfacalcidol is used to treat **hypoparathyroidism**, a condition where the parathyroid glands do not produce enough parathyroid hormone (PTH), leading to low calcium levels in the blood. Alfacalcidol helps by increasing calcium absorption from the intestines. - **Postmenopausal Osteoporosis**: Alfacalcidol may be used in some cases to improve bone density and reduce the risk of fractures in postmenopausal women who have **osteoporosis** due to **low calcium levels** or **vitamin D deficiencies**.

Contra indication

**Alfacalcidol** should not be used in the following situations: - **Hypercalcemia**: It is contraindicated in patients with **elevated calcium levels** in the blood, as this can lead to dangerous consequences like kidney stones or impaired kidney function. - **Hypervitaminosis D**: In patients with **excessive vitamin D levels**, **Alfacalcidol** can exacerbate the condition, leading to further **calcium buildup** and **renal dysfunction**. - **Severe Renal Impairment**: In patients with severe renal dysfunction (such as **end-stage renal disease**), the medication may not be metabolized effectively, resulting in the accumulation of the active form and an increased risk of toxicity. Regular monitoring is needed. - **Hypersensitivity**: People with known hypersensitivity or **allergy** to **Alfacalcidol** or any of its components should not use this medication.

Side Effect

The most common and serious side effects of **Alfacalcidol** include: - **Hypercalcemia**: This is the most significant side effect of **Alfacalcidol** and can lead to **kidney stones**, **bone pain**, **nausea**, **vomiting**, **constipation**, and **abdominal pain**. Regular monitoring of calcium levels is crucial to prevent this. - **Nausea and Vomiting**: These symptoms can occur when calcium levels are too high or when the body adjusts to the medication. - **Fatigue**: Some patients may experience tiredness or general fatigue, especially during the initiation phase of treatment. - **Headache**: **Headaches** can occur, which might be a sign of fluid imbalance or elevated calcium levels. - **Dizziness**: Some people may feel lightheaded, especially when standing up quickly. - **Arrhythmias**: Increased calcium levels in the blood can lead to **heart arrhythmias** or irregular heartbeats. - **Bone Pain**: A side effect related to **vitamin D toxicity** when **Alfacalcidol** is used excessively or without proper monitoring. - **Dry Mouth or Metallic Taste**: Some users experience an unusual taste or dryness in the mouth.

Pregnancy Category ID

0

Mode of Action

**Alfacalcidol** is a **vitamin D analogue** that works by enhancing the intestinal absorption of calcium and phosphate. Once absorbed, it helps regulate calcium levels in the body, which is essential for proper bone mineralization. Alfacalcidol is converted into its active form, **calcitriol**, by the liver. **Calcitriol** binds to **vitamin D receptors** in the intestines, kidney, and bones, promoting the absorption of calcium and phosphate in the intestines, reabsorption in the kidneys, and the release of calcium from bones to the bloodstream. This helps to maintain normal serum calcium levels and promote proper bone health.

Interaction

**Alfacalcidol** may interact with the following substances: - **Thiazide Diuretics**: Medications like **hydrochlorothiazide** can increase the risk of **hypercalcemia** when used in combination with **Alfacalcidol**, as thiazide diuretics reduce calcium excretion. - **Phenytoin and Barbiturates**: These anticonvulsant drugs can decrease the effectiveness of **Alfacalcidol** by accelerating its metabolism in the liver. This can result in a decrease in calcium levels or less efficient treatment for bone diseases. - **Corticosteroids**: Long-term use of corticosteroids, such as **prednisone**, can reduce calcium absorption from the gastrointestinal tract, which may interfere with the action of **Alfacalcidol**. - **Digoxin**: Combining **Alfacalcidol** with digoxin, a medication used to treat heart failure, can increase the risk of **digitalis toxicity**, especially in the presence of elevated calcium levels. - **Magnesium-containing Antacids**: Antacids containing **magnesium** can affect calcium levels and may alter the effectiveness of **Alfacalcidol**. - **Calcium Supplements**: Caution should be used when combining **Alfacalcidol** with calcium supplements, as the increased calcium levels may lead to **hypercalcemia**.

Pregnancy Category Note

Information not available

Adult Dose

The typical starting dose of **Alfacalcidol** in adults is **0.25 to 1 microgram** per day, depending on the severity of the condition and individual patient response. For patients with **renal osteodystrophy** or other calcium-related disorders, higher doses may be required. The dose may be adjusted based on **serum calcium** and **phosphate** levels, typically increasing or decreasing in increments of **0.25 micrograms** every 2-4 weeks until the desired effect is achieved. In some cases, doses up to **3 micrograms per day** may be prescribed for severe hypocalcemia or bone disorders.

Child Dose

The pediatric dose of **Alfacalcidol** depends on the condition being treated and the child’s age. For children with **rickets** or **osteomalacia**, the usual starting dose is **0.01 to 0.05 micrograms per kg of body weight per day**. The dose may be adjusted based on the child’s response and calcium levels. For **neonates** or very young children, lower starting doses are typically used. As with adults, regular monitoring of **serum calcium** and **phosphate** levels is essential during treatment. --- **Important Note**: Before initiating **Alfacalcidol**, it is essential to consult a healthcare provider to determine the appropriate dosage, ensure the medication is safe for you, and monitor your calcium and phosphate levels throughout treatment to avoid complications such as **hypercalcemia**.

Renal Dose

In patients with **renal insufficiency**, **Alfacalcidol** should be used cautiously, and dose adjustments are needed. Since the kidney is responsible for metabolizing **Alfacalcidol** into its active form, reduced kidney function can lead to accumulation. The dose should generally be reduced in patients with **severe renal impairment**, and careful monitoring of **calcium** and **phosphate levels** is necessary to prevent toxicity. The initial dose is often reduced to **0.25 micrograms per day**, and it may be adjusted based on the patient's laboratory results.

Administration

Information not available