Available as:
Indications
Viva-D Capsule is used for:
Hypoparathyroidism, Hypocalcaemia, Renal osteodystrophy, Hypophosphataemia, Rickets or osteomalacia
Adult Dose
Adult:
Patients with severe renal impairment requiring vitamin D therapy
Initially 1 microgram daily, dose to be adjusted to avoid hypercalcemia; maintenance 0.25–1 microgram daily
Child Dose
Child:
PO
Premature infants and neonates: 0.05-0.1 mcg/kg daily; <20 kg: 0.05 mcg/kg daily.
Hypophosphataemic rickets | Persistent hypocalcemia due to hypoparathyroidism or pseudohypoparathyroidism
Child 1 month–11 years: 25–50 nanograms/kg once daily, dose to be adjusted as necessary; maximum 1 microgram per day
Child 12–17 years: 1 microgram once daily, dose to be adjusted as necessary
Prevention of vitamin D deficiency in renal or cholestatic liver disease
Child 1 month–11 years (body weight up to 20 kg): 15–30 nanograms/kg once daily (max. per dose 500 nanograms)
Child 1 month–11 years (body weight 20 kg and above): 250–500 nanograms once daily, dose to be adjusted as necessary
Child 12–17 years: 250–500 nanograms once daily, dose to be adjusted as necessary
Renal Dose
RENAL IMPAIRMENT
Monitor plasma-calcium concentration in renal impairment.
Administration
Administration Should be taken with food.
Contra Indications
Hypercalcaemia, metastatic calcification, hyperphosphataemia (except when occurring with hypoparathyroidism), hypermagnesaemia.
Precautions
Pregnancy, lactation, renal impairment, infants, elderly. Monitor serum levels of calcium in patients with renal failure. Caution in hypercalciuria esp in those with a history of renal calculi. Avoid in patients with hypersensitivity to inj. containing propylene glycol.
Monitoring Parameters
Monitor plasma-calcium concentration in patients receiving high doses.
Pregnancy-Lactation
Interactions
Thiazides may increase the risk of hypercalcaemia. Some antiepileptics e.g. carbamazepine, phenobarbital, phenytoin and primidone may increase vitamin D requirements. Rifampicin, isoniazid and corticosteroids may reduce the efficacy of vitamin D.
Adverse Effects
Side effects of Alfacalcidol :
Anorexia, nausea, vomiting, diarrhoea, lassitude, polyuria, sweating, headache, thirst, vertigo, pruritus, rash, urticaria. Hypercalcaemia, hypercalciuria and ectopic calcification.
In case of renal impairment, hyperphosphataemia. In hypercalcaemic dialysis patients, possibility of calcium influx from the dialysate should be considered.
Mechanism of Action
Alfacalcidol is a precursor of the active calcitriol. It does not require renal hydroxylation but requires 25-hydroxylation in the liver for conversion to calcitriol.
Note
Viva-D 1 mcg Capsule manufactured by Incepta Pharmaceuticals Ltd.. Its generic name is Alfacalcidol. Viva-D is availble in Bangladesh.
DIMS information on Viva-D Capsule is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.