Meditrol Special Precautions

There is a close correlation between treatment with calcitriol and the development of hypercalcaemia.
In patients with normal renal function, chronic hypercalcemia may be associated with an increase in serum creatinine.
Immobilized patients eg, those who have undergone surgery, are particularly exposed to the risk of hypercalcemia.
Calcitriol increases inorganic phosphate levels in serum. While this is desirable in patients with hypophosphatemia, caution is called for in patients with renal failure because of the danger of ectopic calcification.
Patients with vitamin D-resistant rickets (familial hypophosphatemia) who are being treated with calcitriol must continue their oral phosphate therapy; however, possible stimulation of intestinal absorption of phosphate by calcitriol should be taken into account since this effect may modify the need for phosphate supplementation. Since calcitriol is the most effective vitamin D metabolite available, no other vitamin D preparation should be prescribed during treatment with calcitriol, thereby ensuring that the development of hypervitaminosis is avoided.
If the patient is switched from ergocalciferol (vitamin D2) to calcitriol, it may take several months for the ergocalciferol level in the blood to return to the baseline values.
Patients with normal renal function who are taking calcitriol should avoid dehydration. Adequate fluid intake should be maintained.
Hypersensitivity reactions may occur in susceptible individuals.