Look inside the book: Nursing 2025-2026 Drug Handbook

210 calcitriol

• Calcium and vitamin D supplements are recommended in patients with osteoporosis or Paget disease who have inadequate dietary intake. Alert: Systemic allergic reactions are possi ble because the hormone is a protein. Monitor patient for hypersensitivity reactions, includ ing anaphylaxis, and prepare for emergency treatment if needed. Alert: Observe patient for signs of hypocal cemic tetany during therapy (muscle twitch ing, tetanic spasms, and seizures when hypocalcemia is severe). Alert: Periodically reevaluate need for con tinued therapy because of the possible asso ciation between malignancy and long-term calcitonin salmon use. • Monitor calcium level closely. Watch for symptoms of hypercalcemia relapse (bone pain, kidney stones, polyuria, anorexia, nau sea, vomiting, thirst, constipation, lethargy, bradycardia, muscle hypotonicity, pathologic fracture, psychosis, coma). • Be aware that periodic exams of urine sedi ment are recommended. • Be aware that periodic nasal exams with visualization of nasal mucosa, turbinates, sep tum, and mucosal blood vessel status are rec ommended to assess for ulceration in patient using intranasal form. • Be aware that nasal reactions occur more commonly in older adults. • Monitor periodic ALP and 24-hour urine hydroxyproline levels to evaluate drug ef fect. Be aware that, in patient with Paget dis ease, maximum reductions of ALP and uri nary hydroxyproline excretion may take 6 to 24 months of continuous treatment. • In patient with good first response to drug who has a relapse, expect to evaluate antibody response to the hormone protein. • If symptoms have been relieved after 6 months, treatment may be stopped until symptoms or radiologic signs recur. • Look alike–sound alike: Don’t confuse calci tonin with calcifediol or calcitriol. PATIENT TEACHING • When drug is given for Paget disease or postmenopausal osteoporosis, remind patient to take adequate calcium and vitamin D sup plements.

facial flushing and warmth may occur within minutes of injection and usually last about 1hour. • Tell patient that nausea may occur at the on set of therapy. • Instruct patient to promptly report signs and symptoms of hypercalcemia. • Advise patient who is breastfeeding that drug may inhibit lactation. • Teach about proper drug administration and handling, including storage and disposal of injection supplies. calcitriol (1,25 dihydroxycholecalciferol) kal-SIH-trye-ol Rocaltrol, Vectical Therapeutic class: Antihypocalcemics Pharmacologic class: Vitamin D analogues AVAILABLE FORMS Capsules: 0.25 mcg, 0.5 mcg Injection: 1mcg/mL Oral solution: 1mcg/mL Topical ointment: 3mcg/g INDICATIONS & DOSAGES ➤ Hypocalcemia in patients undergoing long-term dialysis (PO) Adults: Initially, 0.25 mcg PO daily. Increase by 0.25 mcg daily at 4- to 8-week intervals. Maintenance oral dosage is 0.25 mcg every other day up to 1 mcg daily (most patients un dergoing hemodialysis respond to doses be tween 0.5 and 1 mcg/day). ➤ Hypocalcemia in patients undergoing long-term dialysis (IV) Adults and children ages 13 and older: Usual IV dosage is 1 to 2 mcg IV three times weekly (approximately every other day). In crease dose by 0.5 to 1 mcg at 2- to 4-week intervals. ➤ Management of secondary hyper parathyroidism and resulting metabolic bone disease in patients with CrCl of 15 to 55 mL/minute Adults and children ages 3 and older: Ini tially, 0.25 mcg PO daily. Increase to 0.5 mcg PO daily, if needed. Children younger than age 3: Initially, 0.01 to 0.015 mcg/kg PO daily.

Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of this content is prohibited. • Inform patient that local inflammatory re actions at subcut or IM injection sites and

Reactions in bold italics are life-threatening .