Alcal Tab 0.5 mcg 10’s-Potential Overview:

Brand Name: Alcal
Generic Name: Alfacalcidol
Active Ingredient(s): Alfacalcidol 0.5 mcg

For the General Public:

Uses:
Alcal (Alfacalcidol) is a vitamin D analog used to manage and prevent conditions caused by calcium deficiency, such as:

• Osteoporosis
• Rickets
• Osteomalacia
• Hypocalcemia (low calcium levels) in patients with chronic kidney disease or hypoparathyroidism

Dosage:

• Adults: Typically, 0.5 mcg to 1 mcg daily, depending on the condition and response.
• Children: Dose adjusted based on age and body weight as prescribed by a doctor.

Possible Side Effects:

• Common Side Effects: Nausea, headache, dry mouth, or fatigue.
• Serious (Less Common) Side Effects: High calcium levels (hypercalcemia), symptoms of which may include vomiting, confusion, excessive thirst, or kidney issues.

Important Information:

• Dosage Instruction: Take exactly as prescribed. Regular monitoring of calcium and phosphate levels is necessary.
• Usage Instruction: Take with or after food to enhance absorption.
• General Information:
  • Do not take this medication if you are allergic to alfacalcidol or have high calcium levels.
  • Inform your doctor if you have kidney or liver problems.
  • If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose. Do not double the dose.

Drug Interactions:

• Interactions with Other Medications: May interact with calcium supplements, antacids, diuretics, or medications for seizures.
• Interactions with Food: Avoid excessive calcium-rich foods or fortified products unless recommended by a doctor.

Regulatory Approval & Manufacturer:
Approved by [regulatory body] and manufactured by [manufacturer name].

Antidotes (If Overdose or Misuse by Patients):
Symptoms of overdose include hypercalcemia. Treatment involves stopping the medication, dietary calcium restriction, and supportive measures like hydration.

For Pharmacists:

Medicine Name: Alcal
Brand: Alcal
Active Ingredient(s): Alfacalcidol 0.5 mcg

Indications:
Indicated for the prevention and management of:

• Renal osteodystrophy in chronic kidney disease
• Hypocalcemia due to hypoparathyroidism or vitamin D deficiency
• Osteoporosis
• Rickets and osteomalacia

Pharmacodynamics:

• Mechanism of Action:
  Alfacalcidol is a precursor to the active form of vitamin D, 1,25-dihydroxyvitamin D3 (calcitriol). It enhances calcium and phosphate absorption in the intestines, promotes bone mineralization, and regulates calcium metabolism.
• Pharmacological Effects:
  • Improves calcium levels in the blood.
  • Supports bone health and reduces the risk of fractures.
• Receptor Binding:
  Binds to vitamin D receptors (VDRs) in the intestine and bone, modulating gene expression to regulate calcium and phosphate homeostasis.

Pharmacokinetics:

• Absorption: Rapidly absorbed after oral administration.
• Distribution: Widely distributed in the body, including bones and soft tissues.
• Metabolism: Rapidly converted in the liver to its active form, calcitriol.
• Elimination: Excreted primarily in bile and feces.
• Half-Life: Approximately 2–4 hours for alfacalcidol; effects last longer due to active metabolite.
• Bioavailability: High, with predictable systemic availability.
• Effect of Food: Food may enhance absorption.

Dosage and Administration:

• Adults: Typically, 0.5 mcg to 1 mcg daily, adjusted based on serum calcium and phosphate levels.
• Pediatric: 0.01–0.05 mcg/kg/day, adjusted as needed.
• Special Populations:
  • Renal impairment: Dosage adjustment required based on calcium and phosphate monitoring.
  • Hepatic impairment: Use with caution due to altered metabolism.

Contraindications:

• Hypercalcemia or evidence of vitamin D toxicity.
• Hypersensitivity to alfacalcidol or any excipients in the formulation.

Warnings and Precautions:

• Regular monitoring of serum calcium, phosphate, and parathyroid hormone (PTH) is essential.
• Use cautiously in patients with a history of hypercalcemia or kidney stones.
• Avoid concurrent use with other vitamin D analogs or high doses of calcium supplements.

Drug-Drug Interactions:

• May interact with thiazide diuretics, increasing the risk of hypercalcemia.
• Reduced efficacy when used with corticosteroids.
• Increased risk of hypermagnesemia when used with magnesium-containing antacids.

Drug-Food Interactions:

• Excessive calcium intake can increase the risk of hypercalcemia.

Adverse Reactions:

• Common: Nausea, vomiting, dry mouth, or headache.
• Serious: Hypercalcemia, nephrocalcinosis, or severe allergic reactions.

Therapeutic Effects:

• Effectively manages calcium and phosphate metabolism disorders.

Storage:
Store at room temperature (15°C to 30°C), in a dry place, away from light and moisture.

Packaging:
Available in tablet form, typically in packs of 10 tablets.

Clinical Considerations:

• Pregnancy Category: C (Use only if potential benefits outweigh risks).
• Lactation Category: Excreted in breast milk; monitor the infant for hypercalcemia.
• Pediatric Category: Safe for use in adjusted doses under medical supervision.
• Geriatric Category: Use cautiously in elderly patients due to the risk of hypercalcemia.

Conclusion:

Alcal Tab 0.5 mcg is a reliable option for managing calcium and bone metabolism disorders, particularly in patients with chronic kidney disease or hypoparathyroidism. Its precise dosing and predictable effects make it a vital treatment for preventing complications like fractures or severe hypocalcemia. Pharmacists should emphasize adherence to prescribed doses, regular lab monitoring, and avoiding excessive calcium intake. Proper patient education is essential for safe and effective use.