Alfacalcidol

Alfacalcidol is a vitamin D analog that requires hepatic conversion to the active form calcitriol (1,25-dihydroxyvitamin D₃). It plays a crucial role in regulating calcium and phosphate metabolism, promoting bone mineralization, and supporting normal parathyroid function. It is primarily used in the prevention and treatment of conditions associated with abnormal calcium homeostasis.

✅ Approved & Common Indications

🌿 Renal Osteodystrophy (Secondary Hyperparathyroidism in Chronic Kidney Disease - CKD)

• Indicated for the management of secondary hyperparathyroidism, osteomalacia, and disturbances of calcium metabolism in patients with chronic kidney disease (CKD).
• Corrects impaired calcium absorption and reduces elevated parathyroid hormone (PTH) levels, preventing renal osteodystrophy.

🌿 Hypocalcemia

• Indicated for the prevention and treatment of hypocalcemia in various clinical settings, especially in patients with impaired renal function who cannot adequately convert vitamin D to its active form.

🌿 Osteomalacia

• Indicated for the treatment of osteomalacia (bone softening due to defective bone mineralization), particularly when caused by vitamin D deficiency, malabsorption, or chronic renal insufficiency.

🌿 Hypoparathyroidism

• Indicated for the management of hypocalcemia associated with hypoparathyroidism (post-surgical, idiopathic, or genetic), improving calcium absorption and serum calcium levels.

🌿 Rickets

• Indicated for the treatment of rickets in children and adults due to vitamin D-dependent or vitamin D-resistant conditions, or chronic kidney disease.

🌿 Postmenopausal Osteoporosis (Adjunctive Therapy)

• Used as adjunctive therapy in the management of postmenopausal osteoporosis, in combination with calcium and/or other osteoporosis treatments, to improve bone mineral density and reduce fracture risk.

🌿 Other Potential Uses (Off-label / Regional Guidelines)

Alfacalcidol has also been employed in:

• Prevention of bone loss in patients undergoing long-term corticosteroid therapy
• Osteogenesis imperfecta (as supportive therapy in selected cases)
• Management of calcium and phosphate imbalances in specific endocrine disorders