November 28, 2022

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Difference of anti-osteoporosis drugs: Vitamin D Calcitriol and Alfacalcido

Difference of anti-osteoporosis drugs: Vitamin D Calcitriol and Alfacalcido



 

 

Difference of anti-osteoporosis drugs: Vitamin D Calcitriol and Alfacalcido.  What are the differences between anti-osteoporosis drugs vitamin D, calcitriol and alfacalcidol?

 

Difference of anti-osteoporosis drugs: Vitamin D Calcitriol and Alfacalcido.  What are the differences between anti-osteoporosis drugs vitamin D, calcitriol and alfacalcidol?

 

 

Osteoporosis is a systemic metabolic disease that is prone to fractures and other complications. It is one of the common causes of disability and death in the elderly.

There are many drugs to prevent and treat osteoporosis, and vitamin D and its active metabolites (such as calcitriol, alfacalcidol) are one of the most common drugs.

The reason is that it can promote calcium absorption and participate in immune regulation. . So, what is the difference between vitamin D, calcitriol and alfacalcidol? Today, the author will sort out the differences between these three osteoporosis prevention and treatment drugs.

 

 

 

The difference between vitamin D, calcitriol and alfacalcidol:

 

1. Different metabolic pathways in the body

After vitamin D enters the body, it is first activated in the liver, and then transported to the kidney for the second step of activation, and finally converted into active vitamin D-calcitriol.

Alfacalcidol, after ingested in the body, only needs to be activated in one step in the liver before it can be converted into calcitriol and absorbed by the body.

Calcitriol itself is already activated vitamin D, which can be directly absorbed.

 

2. Different indications

In addition to osteoporosis, the indications of the three drugs are very different, as detailed below:

1) Vitamin D: prevention and treatment of vitamin D deficiency and tetany; treatment of chronic hypocalcemia and hypophosphatemia; prevention and treatment of senile osteoporosis, rickets and osteomalacia; adjuvant treatment of elderly fractures and hypoparathyroidism disease.

2) Calcitriol: used to treat osteoporosis, renal osteodystrophy and other diseases in chronic renal failure patients undergoing hemodialysis.

3) Alfacalcidol: used to treat and improve chronic renal insufficiency, hypothyroidism and osteoporosis.

 

3. Adapt to different people

Adults with normal liver and kidney function and no osteoporosis are advised to take vitamin D, because vitamin D itself also has an immunomodulatory effect.

If the kidney function is not good, but the liver function is still normal, you can take alfacalcidol.

If the liver and kidney functions are not good, calcitriol can be used to prevent or treat osteoporosis.

 

4. Different contraindications

1) Vitamin D: It is forbidden for patients with hypervitaminosis D, hypercalcemia, hyperphosphatemia and renal rickets.

2) Calcitriol: it is forbidden for patients with hypercalcemia and vitamin D poisoning.

3) Alfacalcidol: It is forbidden for patients with hypercalcemia, hyperphosphatemia, and signs of vitamin D poisoning.

 

5. Different pharmacokinetics

1) Vitamin D: It is transformed into a variety of active metabolites in the body to play a role.

2) Calcitriol: It is rapidly absorbed in the intestine, reaching a steady-state blood concentration in 7 days, with a half-life of 3-6 hours, and a single-dose pharmacological effect lasts for 3 to 5 days.

3) Alfacalcidol: After oral administration, it is absorbed through the small intestine and converted into calcitriol in liver osteoblasts to play a role.

 

6. Different drug interactions

1) Vitamin D: Drug interactions with phenobarbital, phenytoin, sucralfate, aluminum hydroxide, etc. may occur.

2) Calcitriol: It may interact with vitamin D and its derivatives, thiazide diuretics, digitalis drugs, hormones, etc.

3) Alfacalcidol: Drug interactions may occur with anticoagulants, antiepileptic drugs, aluminum antacids, magnesium or calcium preparations, etc.

 

 

 


Conclusion

Vitamin D, calcitriol and alfacalcidol, although these three drugs come from the same family, they have great significance in indications, adverse reactions, contraindications, pharmacokinetics, drug interactions, and precautions. different. When choosing, we should choose rationally based on the difference between the three drugs.

Generally speaking, people with renal insufficiency should use vitamin D with caution, and calcitriol and alfacalcidol should be used.

 

 

 

Difference of anti-osteoporosis drugs: Vitamin D Calcitriol and Alfacalcido

(source:internet, reference only)


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