Alpha D3-Teva® (Alpha D3-Teva®)

Pay attention to patients taking cardiac glycosides, as hypercalcemia can lead to the development of arrhythmia in such patients.

Attention should be paid to patients taking thiazide diuretics, since such patients may increase the risk of developing hypercalcemia.

The effectiveness of alfacalcidol is generally maintained in patients with reduced liver function. In severe hepatic insufficiency, the concentration of the active metabolite of 1,25-dihydroxyvitamin D can be reduced by decreasing the hydroxylation process or by decreasing the enterohepatic circulation. In this case, it may be necessary to administer the drug at higher doses.

When applying the drug in the elderly, dose adjustments are not required.

The drug can promote the development of hypercalcemia, so patients should be informed about the clinical symptoms of this condition (see the section "Overdose"). During the use of the Alpha D3-Teva® preparation, the concentration of calcium, phosphate, calcium-phosphate compounds, alkaline phosphatase and the level of parathyroid hormone in the blood serum should be regularly monitored.

The concentration of calcium should be determined once a week or a month, depending on the clinical situation.More frequent measurement of calcium is required at the beginning of treatment, especially in conditions without significant bone damage, for example, hypoparathyroidism, and if the calcium content in the plasma is already increased, as well as at later stages of treatment with signs of bone structure restoration. The risk of developing hypercalcemia is determined by such factors as: degree demineralization of bone, the functional capacity of the kidneys and the dose of the drug Alpha D3-Teva®. The appearance of hypercalcemia can be due to the fact that the dose of the drug does not decrease in a timely and adequate manner in the presence of biochemical signs of the restoration of the structure of bone tissue (normalization of alkaline phosphatase in the blood). It is necessary to prevent the development of prolonged hypercalcemia, especially in chronic renal failure, focusing on such factors as concentration in the serum of calcium, alkaline phosphatase, parathyroid hormone, the amount of calcium excreted in the urine, radiological and biochemical data.

With the development of hypercalcemia or a persistent increase in the level of calcium phosphate compounds, which goes beyond the clinical norm, the drug should be immediately canceled, at least,until these parameters are normalized (usually within one week), then the drug can be resumed at a dose that is half that of the previous one.

Patients with severe bone damage (in contrast to patients with renal insufficiency) can tolerate higher doses of the drug without signs of hypercalcemia. The lack of a rapid increase in serum calcium in patients with osteomalacia does not necessarily mean that the dose of the drug should be increased, since calcium can penetrate into the demineralized bone due to its increased absorption in the intestine.

It is necessary to avoid excessive suppression of parathyroid hormone. For patients on dialysis, the level of parathyroid hormone in serum should be consistent with the current treatment guidelines.

To prevent the development of hyperphosphataemia in patients with bone lesions of renal genesis, alfacalcidol can be used together with phosphate binding agents.

In osteoporosis, the use of the Alpha D3-Teva® drug can be combined with estrogens and antiresorptive drugs.

The composition of excipients of the drug includes peanut butter.Patients with an allergic reaction to peanut butter and soy bean is contraindicated.