디히드로타키스테롤

용도

• Hypocalcemia secondary to hypoparathyroidism
• Chronic hypocalcemia with oral calcium tx
• Hypocalcemia secondary to hypoparathyroidism

투여 방법

가능한 부작용

• Hypercalcemia (manifesting as polydipsia, polyuria, anorexia, vomiting, lethargy)
• Nephrocalcinosis (soft tissue mineralization)
• Hyperphosphatemia

주의사항 및 금기

• Pre-existing hypercalcemia
• Vitamin D toxicity
• Malabsorption syndromes
• Abnormal sensitivity to the effects of vitamin D
• ### Important Warnings * **Hyperphosphatemia**: Use with extreme caution. Many clinicians consider hyperphosphatemia or a combined calcium/phosphorus product of >70 mg/dL to be an absolute contraindication due to the risk of metastatic soft tissue mineralization (nephrocalcinosis). * **Renal Dysfunction**: Use with extreme caution when receiving the drug for non-renal indications. * **Pregnancy**: FDA Category C. Hypervitaminosis D has caused fetal abnormalities in various species. Weigh risks vs. benefits. * **Nursing**: Vitamin D is excreted in breast milk in limited amounts; use with caution. * **Laboratory Interference**: Serum cholesterol levels may be falsely elevated by vitamin D analogs when using the Zlatkis-Zak reaction.

약물 상호작용

• Calcium-containing phosphorus binding agents (e.g., calcium carbonate): Use with vitamin D analogs may induce severe hypercalcemia.
• Corticosteroids: Can nullify the calcium-elevating effects of vitamin D analogs.
• Digoxin: Patients are highly sensitive to the arrhythmogenic effects of hypercalcemia; intensified monitoring is required.
• Verapamil: Patients are sensitive to the effects of hypercalcemia; intensified monitoring is required.
• Mineral oil: May reduce the amount of DHT absorbed from the GI tract.
• Sucralfate: May reduce the amount of DHT absorbed from the GI tract.
• Cholestyramine: May reduce the amount of DHT absorbed from the GI tract.
• Phenytoin: May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.
• Barbiturates: May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.
• Primidone: May induce hepatic enzyme systems and increase the metabolism of Vitamin D analogs, thus decreasing their activity.

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