Calcitriol Side Effects
Not all side effects for calcitriol may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
For the Consumer
Applies to calcitriol: oral capsules, oral solution, parenteral injection
Side effects include:
Excessive vitamin D intake (early manifestations): weakness, headache, somnolence, nausea, dry mouth, constipation, muscle or bone pain, metallic taste.
Excessive vitamin D intake (late manifestations): polyuria, polydipsia, anorexia, weight loss, nocturia, calcific conjunctivitis, pancreatitis, photophobia, rhinorrhea, pruritus, hyperthermia, decreased libido, elevated BUN, albuminuria, hypercholesterolemia, elevated AST, elevated ALT, ectopic calcification, nephrocalcinosis, hypertension, cardiac arrhythmias, dystrophy, sensory disturbances, dehydration, apathy, arrested growth, urinary tract infections.
For Healthcare Professionals
Applies to calcitriol: injectable solution, oral capsule, oral liquid
Early signs and symptoms of hypercalcemia include headache, anorexia, nausea, vomiting, metallic taste, constipation, abdominal cramps, dry mouth, weakness, fatigue, muscle and bone pain, ataxia, tinnitus, abdominal pain, and vertigo. Later hypercalcemia may result in pruritus, mental confusion, coma, elevated hepatic transaminase levels, hypertension, cardiac arrhythmias, seizures, metastatic calcification, and renal insufficiency manifested by polyuria, nocturia, polydipsia, and proteinuria and elevated BUN.
In one study, the incidence of hypercalcemia was lower (50% vs 80%) when calcitriol was administered at night as opposed to morning administration. Hypercalcemia also appears to occur more commonly in patients receiving intermittent vs. continuous therapy and in oral vs. intravenous therapy.
Patients with renal failure are more prone to the development of hypercalcemia because the urinary excretion of calcium cannot compensate for increases in serum calcium.
Increased phosphate absorption may be detrimental in patients with chronic renal failure and hyperphosphatemia.[Ref]
Metabolic side effects have included hypercalcemia and increased phosphate absorption.[Ref]
Hypersensitivity side effects have included rare cases of hypersensitivity reactions, including anaphylaxis. A single case of erythema multiform has been reported. Another case involving a single patient experiencing an allergic reaction including total body hives and swelling of the lips has also been reported.[Ref]
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9. Arik N, Basoglu T, Sungur C, Adam B, Bedir A, Kandemir T, Coskun C, Bernay I "Hyperphosphatemia: A serious limiting factor preventing the possible benefit from intravenous calcitriol therapy." Nephron 82 (1999): 77-8
10. Mazess RB, Elangovan L "A review of intravenous versus oral vitamin D hormone therapy in hemodialysis patients." Clin Nephrol 59 (2003): 319-25
11. Herrmann P, Ritz E, Schmidt-Gayk H, Schafer I, Geyer J, Nonnast-Daniel B, Koch KM, Weber U, Horl W, Haas-Worle A, et al "Comparison of intermittent and continuous oral administration of calcitriol in dialysis patients: a randomized prospective trial." Nephron 67 (1994): 48-53
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