calcitriol in osteoporosis

Last reviewed 01/2018

Calcitriol is licensed for the treatment of postmenopausal osteoporosis.

• is the active form of vitamin D and is approved for the treatment of established postmenopausal osteoporosis in a dose of 0.25µg twice daily.
• acts mainly by inhibiting bone resorption
• has been shown to reduce vertebral fracture risk in postmenopausal women with osteoporosis but effects on non-vertebral and hip fractures have not been established
• contraindicated in patients with hypercalcaemia and because it may cause hypercalcaemia and/or hypercalciuria, serum calcium and creatinine levels should be monitored at 1, 3 and 6 months after starting treatment and at 6 monthly intervals thereafter

Note that all patients receiving pharmacological doses of vitamin D should have the plasma-calcium concentration checked at intervals (initially weekly) and whenever nausea or vomiting are present (2).

Reference:

1. National Osteoporosis Society (2008). Guideline for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK
2. Royal College of Physicians. Osteoporosis Clinical guidelines for prevention and treatment of osteoporosis. London, 1999.
3. BNF 9.6.4
4. Drug and Therapeutics Bulletin 1996; 34 (11):84-6.
5. Sambrook P et al. A comparison of calcium, calcitriol, and calcitonin. NEJM 1993; 328: 1747-52.