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The natural, active form of vitamin D is calcitriol (1,25-dihydroxycholecalciferol). This molecule and other naturally occurring forms of vitamin D, including its precursors and metabolites, have been modified to synthesize pharmaceuticals with potentially greater, or selective, therapeutic actions. [1] [2] [3] [4]
It is used to prevent and treat lack of calcium and vitamin D in the elderly, as well for osteoporosis in combination with other medications. [ 1 ] [ 2 ] In 2022, the combination, calcium/vitamin D was the 246th most commonly prescribed medication in the United States, with more than 1 million prescriptions.
effective in hypercalcemia due to malignancy with elevated vitamin D levels (many types of malignancies raise the vitamin D level). [22] also effective in hypervitaminosis D and sarcoidosis; dialysis usually used in severe hypercalcaemia complicated by kidney failure. Supplemental phosphate should be monitored and added if necessary
Alfacalcidol (or 1-hydroxycholecalciferol) is an analogue of vitamin D used for supplementation in humans and as a poultry feed additive. Alfacalcidol has a weaker impact on calcium metabolism [ 3 ] and parathyroid hormone levels [ 4 ] than calcitriol ; but significant effects on the immune system , including regulatory T cells . [ 5 ]
In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone, vitamin D and the calcium sensing receptor. [1] Disorders in calcium metabolism can lead to hypocalcemia, decreased plasma levels of calcium or hypercalcemia, elevated plasma calcium levels.
The uses of bisphosphonates include the prevention and treatment of osteoporosis, Paget's disease of bone, bone metastasis (with or without hypercalcemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that exhibit bone fragility.
In 2021, it was the 235th most commonly prescribed medication in the United States, with more than 1 million prescriptions. [7] [8] Versions are also sold together with vitamin D. [3] In 2020, the combination, calcium/vitamin D was the 215th most commonly prescribed medication in the United States, with more than 2 million prescriptions. [9] [10]
1α-Hydroxyvitamin D 5 is a chemical derivative of vitamin D 5.The motive to study 1α-hydroxyvitamin D 5 as a potential pharmaceutical drug stemmed from the tendency of calcitriol, a natural metabolite produced in the kidney, to cause toxic hypercalcemia in patients when dosed at concentrations needed to interrupt prostate cancer cells' cycle and stimulate apoptosis.