Home Drug Guide Calcifediol

Drug Guide

Generic Name

Calcifediol

Brand Names Calderol, Rayaldee

Classification

Therapeutic: Vitamin D analog, Mineral and electrolyte replenisher

Pharmacological: Active vitamin D3 (calcifediol)

FDA Approved Indications

Treatment of vitamin D deficiency

Mechanism of Action

Calcifediol increases serum 25-hydroxyvitamin D levels by being the circulating form of vitamin D3, which is metabolized in the liver from cholecalciferol. It promotes intestinal absorption of calcium and phosphate, aiding in mineralization of bone.

Dosage and Administration

Adult: The dosage varies based on the condition; for vitamin D deficiency, typically 0.266 mg (equivalent to 7.5 mcg) orally once daily, titrated based on serum levels.

Pediatric: Use in children is based on clinical judgment and serum vitamin D levels; dosing must be individualized under medical supervision.

Geriatric: No specific dose adjustment, but monitor renal and hepatic function.

Renal Impairment: Dose adjustments may be necessary; monitor serum calcium and vitamin D levels.

Hepatic Impairment: No specific adjustments; use with caution and monitor serum levels.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract

Distribution: Bound largely to plasma proteins, especially vitamin D binding protein

Metabolism: Metabolized in the liver to the active form, calcitriol

Excretion: Excreted mainly via the biliary route into feces; minimal renal excretion

Half Life: Approximately 15 days

Contraindications

Hypercalcemia
Hypervitaminosis D

Precautions

Renal impairment, especially with a history of hypercalcemia or calcium nephrolithiasis; monitor calcium and vitamin D levels regularly

Adverse Reactions - Common

Hypercalcemia (Less common)
Gastrointestinal discomfort (Common)

Adverse Reactions - Serious

Nephrolithiasis (kidney stones) (Uncommon)
Hypercalcemia leading to soft tissue calcification (Rare)

Drug-Drug Interactions

Thiazide diuretics (risk of hypercalcemia)
Digoxin (risk of toxicity with hypercalcemia)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor serum calcium, phosphate, 25-hydroxyvitamin D, and renal function periodically.

Diagnoses:

Risk for hypercalcemia

Implementation: Administer as prescribed, typically with food to enhance absorption. Educate patient on symptoms of hypercalcemia.

Evaluation: Assess serum calcium levels regularly; adjust dose accordingly.

Patient/Family Teaching

Take medication with food.
Report symptoms of hypercalcemia (e.g., weakness, confusion, nausea, vomiting).
Maintain adequate hydration.
Avoid excessive calcium or vitamin D intake unless directed by healthcare provider.

Special Considerations

Black Box Warnings:

None specific for calcifediol.

Genetic Factors: Genetic polymorphisms may affect vitamin D metabolism, impacting serum levels and response.

Lab Test Interference: Potential interference with calcium and vitamin D laboratory assays.

Overdose Management

Signs/Symptoms: Hypercalcemia symptoms such as nausea, vomiting, weakness, frequent urination, and confusion.

Treatment: Discontinue calcifediol, administer IV fluids, and use medications such as corticosteroids or bisphosphonates if severe.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended storage conditions.