Viva-D 1 mcg

Alfacalcidol stimulates intestinal calcium and phosphorus absorption, the reabsorption of calcium from bone and possibly the renal reabsorption of calcium. In the majority of patients treated with Alfacalcidol, clinical symptoms of bone pain and muscle weakness begin to remit within 2 weeks to 3 months of the start of therapy. Malabsorption of calcium is rapidly corrected. In patients on daily oral therapy, plasma alkaline phosphatase and PTH levels generally begin to fall within 3 months, but plasma calcium levels may not normalize for several months. This delay should not necessarily be construed as a poor response but may indicate that calcium is being utilized for bone mineralization. The decrease in PTH levels may be more rapid in patients on intermittent intravenous therapy, with significant reductions being achieved within 3 months of therapy.

An initial dose of 0.25 mcg/day is recommended for the first 2 months, unless hypercalcemia develops. If hypercalcemia occurs then the dose should be reduced to 0.25 mcg on alternate days. If serum calcium is below the desired range, the dose may be adjusted in increments of 0.25 mcg/day every 2 months.

Maintenance Doses: Most patients will be maintained on a dose of 0.5 mcg/day. However, doses up to 1 mcg/day may be necessary to maintain serum calcium within the desired range. Serum calcium and phosphate levels should be monitored at monthly intervals or as is considered necessary if hypercalcemia develops. If hypercalcemia develops at any time during treatment then the dose of alfacalcidol should be reduced by 50% and all calcium supplements stopped until calcium levels return to normal.

Pediatrics: The safety and efficacy of Alfacalcidol in children has not been established.