Повышенное содержание кальция в крови (у лиц с усиленной; функцией паращитовидных желез, гипервитаминозом D, остеохондрозом, метастазами опухолей в кости)
Гиперфосфатемия (за исключением случаев, когда последняя; развивается на фоне гипопаратиреоидизма)
Альфакальцидол 0.25 мкг; кальций (в форме кальция карбоната из раковин устриц) 200 мг
Фармакологические свойства
Комбинированный препарат, регулирующий обмен кальция и фосфора. Восполняет недостаток кальция и витамина D3 в организме.; Основными терапевтическими эффектами альфакальцидола являются повышение концентрации 1,25-гидроксиколекальциферола в крови и, как следствие этого, усиление абсорбции кальция и фосфата; улучшение минерализации и уменьшение резорбции костной ткани, нормализация содержания паратиреоидного гормона в плазме, уменьшение костных и мышечных болей.; Кальций участвует в формировании костной ткани, процессе свертывания крови, передаче нервных импульсов, сокращениях скелетных мышц, регуляции работы сердца.; Обоснование комбинации альфакальцидола и кальция; Альфакальцидол усиливает абсорбцию кальция из ЖКТ и вызывает терапевтический эффект при остеопорозе. Содержание элементарного кальция в кальция карбонате составляет 40%, т.е. в 500 мг кальция карбонате содержится 200 мг элементарного кальция, что соответствует минимальной физиологической потребности.
Показания к применению
Остеопороз (менопаузный, сенильный, стероидный, идиопатический и другие) и его осложнения (переломы костей)
Почечная остеодистрофия
Гипопаратиреоидизм и гиперпаратиреоидизм (с поражением костей)
Повышенное содержание кальция в крови (у лиц с усиленной; функцией паращитовидных желез, гипервитаминозом D, остеохондрозом, метастазами опухолей в кости)
Гиперфосфатемия (за исключением случаев, когда последняя; развивается на фоне гипопаратиреоидизма)
Гипермагниемия
Синдром Золлингера
Непереносимость арахиса или сои
Детский возраст до 18 лет
С осторожностью принимать лицам, страдающим почечной недостаточностью, а также пациентам на гемодиализе. В случае длительного лечения необходимо проверять количество кальция, выделяемого почками.
Применение при беременности и в период грудного вскармливания
Исследования не проводились, поэтому препарат противопоказан в период беременности и кормления грудью.; При беременности препарат назначают только по абсолютным показаниям и только в том случае, если потенциальная польза его применения превышает возможный риск для плода. Гиперкальциемия во время беременности может влиять на развитие плода. Суточная доза не должна превышать 1500 мг кальция карбоната.
Способ применения и дозы
При остеопорозе - по 1-2 капсулы в сутки.; При остеодистрофии при хронической почечной недостаточности - по 2 капсулы в сутки.; При гипопаратиреозе и гиперпаратиреозе (с поражением костей) - по 1-2 капсулы в сутки.; Хроническая почечная недостаточность - по 1-2 капсулы в сутки.; Продолжительность приема препарата определяется врачом.
Побочное действие
Со стороны процессов обмена веществ: гиперкальциемия. У пациентов с выраженным нарушением функции почек возможно развитие гиперфосфатемии.; Со стороны пищеварительной системы: запор, диарея.; Со стороны мочевыделительной системы: нефрокальциноз.; Аллергические реакции: зуд, сыпь, крапивница.
Передозировка
При развитии гиперкальциемии следует прекратить прием препарата.; Гиперкальциемия проявляется как недомогание, усталость, слабость, головокружение, сонливость, головная боль, тошнота, сухость во рту, запор, диарея, изжога, рвота, боли в животе, желудочно-кишечные расстройства, мышечные боли, боли в костях, боли в суставах, зуд.; Лечение: следует отменить прием препарата. Тяжелая форма гиперкальциемии требует проведение поддерживающих лечебных мероприятий - проводят гидратацию с введением инфузионных солевых растворов, в некоторых случаях - назначение "петлевых" диуретиков, кортикостероидов.; В случаи острой передозировки необходимо проводить предварительное лечение промыванием желудка и/или введением минерального масла, что способствует уменьшению всасывания и увеличению выведения препарата через кишечник.
Особые указания
Альфакальцидол является активным производным витамина D3. Во время лечения не следует назначать терапевтические дозы витамина D3 и его производных вследствие возможности аддитивных эффектов и повышенного риска гиперкальциемии.; Препарат усиливает кишечную абсорбцию кальция и фосфата, концентрацию которых необходимо контролировать, особенно у пациентов с почечной недостаточностью. Необходимо проводить мониторинг концентраций кальция, фосфата, щелочной фосфатазы, магния и креатинина.; При возникновении гиперкальциемии или гиперкальциурии их можно быстро устранить путем отмены препарата до нормализации концентрации кальция в плазме. Препарат следует применять с осторожностью у пациентов с гиперкальциурией, в частности у лиц с мочекаменной болезнью.; Влияние на способность к вождению автотранспорта и управлению механизмами; Препарат не оказывает влияние на вождение автотранспорта и занятия другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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