Регулятор обмена кальция и фосфора, 1α-гидроксивитамин D3. В... Инструкция
Показания к применению
Остеодистрофия (в т.ч. при хронической почечной недостаточности), гипопаратиреоз и псевдогипопаратиреоз, рахит и остеомаляция различного генеза, остеопороз (в т.ч. постменопаузный, сенильный, стероидный), почечный ацидоз, синдром Фанкони (наследственный почечный ацидоз с нефрокальцинозом, поздним рахитом и адипозогенитальной дистрофией).
Противопоказания
Гиперкальциемия, гиперфосфатемия (за исключением гиперфосфатемии при гиперпаратиреозе), гипермагниемия, гипервитаминоз D, период лактации (грудного вскармливания), детский возраст до 3 лет, повышенная чувствительность к альфакальцидолу.
Регулятор обмена кальция и фосфора, 1α-гидроксивитамин D3. Вызывает повышение абсорбции кальция и фосфора в кишечнике, увеличение их реабсорбции в почках; регулирует минерализацию костной ткани. Восстанавливает положительный кальциевый баланс при лечении синдрома кальциевой мальабсорбции и снижает концентрацию в крови паратиреоидного гормона.
Воздействуя на обе части процесса костного ремоделирования (резорбцию и синтез), альфакальцидол не только увеличивает минерализацию костной ткани, но и повышает ее упругость за счет стимулирования синтеза белков матрикса кости, костных морфогенетических белков, факторов роста кости, что способствует уменьшению частоты развития переломов.
У пациентов пожилого возраста на фоне эндокринно-иммунной дисфункции, в т.ч. дефицита продукции D-гормона (кальцитриола), происходит снижение общей мышечной массы (саркопения) и появление синдрома мышечной слабости (вследствие нарушения нормального функционирования нервно-мышечного аппарата), что сопровождается повышением риска падений и обусловленных этим травм и переломов. В ряде исследований было показано значительное снижение частоты падений пациентов пожилого возраста при применении альфакальцидола.
Альфакальцидол стимулирует регенерацию мышечных волокон, что восстанавливает утраченный мышечный тонус.
Показания к применению
Остеодистрофия (в т.ч. при хронической почечной недостаточности), гипопаратиреоз и псевдогипопаратиреоз, рахит и остеомаляция различного генеза, остеопороз (в т.ч. постменопаузный, сенильный, стероидный), почечный ацидоз, синдром Фанкони (наследственный почечный ацидоз с нефрокальцинозом, поздним рахитом и адипозогенитальной дистрофией).
Противопоказания
Гиперкальциемия, гиперфосфатемия (за исключением гиперфосфатемии при гиперпаратиреозе), гипермагниемия, гипервитаминоз D, период лактации (грудного вскармливания), детский возраст до 3 лет, повышенная чувствительность к альфакальцидолу.
Применение при беременности и в период грудного вскармливания
Применение при беременности возможно только в случаях, когда ожидаемая польза терапии для матери превышает потенциальный риск для плода.
Применение в период лактации (грудного вскармливания) противопоказано.
Способ применения и дозы
Индивидуальный. Суточная доза для взрослых варьирует от 0.07 мкг до 20 мкг, для детей в возрасте старше 3 лет - 0.01-0.08 мкг/кг.
Побочное действие
Со стороны пищеварительной системы: анорексия, тошнота, рвота, сухость во рту, дискомфорт в области эпигастрия, запор; редко - незначительное повышение активности АЛТ, АСТ.
Со стороны ЦНС: слабость, утомляемость, головокружение, сонливость.
Со стороны сердечно-сосудистой системы: тахикардия.
Аллергические реакции: кожная сыпь, зуд.
Со стороны обмена веществ: редко - повышение ЛПВП в плазме; при выраженных нарушениях функции почек - гиперфосфатемия.
Взаимодействие с другими лекарственными средствами
При одновременном применении со средствами, вызывающими индукцию микросомальных ферментов печени, терапевтический эффект альфакальцидола уменьшается (следует использовать более высокую дозу альфакальцидола).
При одновременном применении альфакальцидола с препаратами наперстянки повышается риск развития аритмии; с препаратами кальция, тиазидными диуретиками - повышается риск развития гиперкальциемии; с антацидами или слабительными средствами - повышается риск развития гипермагниемии.
Противоэпилептические препараты, фенитоин, барбитураты, уменьшают эффективность альфакальцидола; минеральные масла, колестирамин, колестипол, сукральфат, антациды, альбумин уменьшают его всасывание. Одновременное проведение лаксативодиализа повышает риск развития гипермагниемии и гипералюминемии.
Не следует применять одновременно с колекальциферолом (витамином D) и его производными.
Особые указания
С осторожностью следует применять у пациентов с нефролитиазом, атеросклерозом, хронической сердечной недостаточностью, хронической почечной недостаточностью, при саркоидозе или других гранулематозах, туберкулезе легких (активная форма), у пациентов с повышенным риском развития гиперкальциемии, особенно при наличии мочекаменной болезни, у детей в возрасте старше 3 лет.
В период лечения следует регулярно контролировать уровень кальция в плазме крови и моче, наблюдать за развитием терапевтического эффекта и при необходимости корректировать дозу альфакальцидола во избежание развития гиперкальциемии и гиперкальциурии.
В отличие от природного витамина D альфакальцидол не метаболизируется в почках. Имеются сообщения об эффективности альфакальцидола при вторичном гиперпаратиреоидизме, обусловленном почечной недостаточностью.
Форма выпуска
Раствор для приема внутрь в масле прозрачный, от светло-желтого до желтого цвета.
Условия хранения
В защищенном от света месте, при комнатной температуре
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В ряде исследований было показано значительное снижение частоты падений пациентов пожилого возраста при применении альфакальцидола."}},{"type":"paragraph","data":{"text":"Альфакальцидол стимулирует регенерацию мышечных волокон, что восстанавливает утраченный мышечный тонус."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Остеодистрофия (в т.ч. при хронической почечной недостаточности), гипопаратиреоз и псевдогипопаратиреоз, рахит и остеомаляция различного генеза, остеопороз (в т.ч. постменопаузный, сенильный, стероидный), почечный ацидоз, синдром Фанкони (наследственный почечный ацидоз с нефрокальцинозом, поздним рахитом и адипозогенитальной дистрофией)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперкальциемия, гиперфосфатемия (за исключением гиперфосфатемии при гиперпаратиреозе), гипермагниемия, гипервитаминоз D, период лактации (грудного вскармливания), детский возраст до 3 лет, повышенная чувствительность к альфакальцидолу."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение при беременности возможно только в случаях, когда ожидаемая польза терапии для матери превышает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Применение в период лактации (грудного вскармливания) противопоказано."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Индивидуальный. 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Одновременное проведение лаксативодиализа повышает риск развития гипермагниемии и гипералюминемии."}},{"type":"paragraph","data":{"text":"Не следует применять одновременно с колекальциферолом (витамином D) и его производными."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"С осторожностью следует применять у пациентов с нефролитиазом, атеросклерозом, хронической сердечной недостаточностью, хронической почечной недостаточностью, при саркоидозе или других гранулематозах, туберкулезе легких (активная форма), у пациентов с повышенным риском развития гиперкальциемии, особенно при наличии мочекаменной болезни, у детей в возрасте старше 3 лет."}},{"type":"paragraph","data":{"text":"В период лечения следует регулярно контролировать уровень кальция в плазме крови и моче, наблюдать за развитием терапевтического эффекта и при необходимости корректировать дозу альфакальцидола во избежание развития гиперкальциемии и гиперкальциурии."}},{"type":"paragraph","data":{"text":"В отличие от природного витамина D альфакальцидол не метаболизируется в почках. 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