Calcitriol versus Paricalcitol for Vitamin D deficiency

[kamalshah20]

I was put on Calcitriol 0.25 mcg per day a couple of days back to treat my Vit D deficiency. I have had a high PTH for months now and I am on Cinacalcet for that.

I was looking up Calcitriol on the internet and I found two bits of information - one which said that calcitriol is contraindicated in treating Vit D deficiency (http://www.vitamindcouncil.org/treatment.shtml) and one more that said that paricalcitol (Zemplar) was better than calcitriol (http://content.nejm.org/cgi/content/full/349/5/496) in terms of causing hypercalcemia. I'm wondering then about why I was put on calcitriol as opposed to paricalcitol?

Any thoughts?

Thanks
Kamal
http://kamaldshah.com

[Zach]

I'm on IV Zamplar after each treatment, and it works to some degree without raising calcium too much.
Calcitriol, I believe, is an older medicine and thus less expensive, especially if it's in the oral form.

[Marsh]

I'm on Zemplar and it is very expensive ($360/month), and my insurance doesn't cover it.  But, the drug company has a program where I only have to pay 20%.  So, that helps a lot.

[kamalshah20]

Ok. Thanks Zach and Marsh for your replies.

One thing I found is that Calcitriol causes an increase in phosphorus apart from an increase in Calcium. I've been struggling  with a low phosphorus ever since I started nocturnal dialysis. So, maybe, it might be good to take Calcitriol.

Thanks
Kamal
http://kamaldshah.com

[Zach]

I've been struggling  with a low phosphorus ever since I started nocturnal dialysis. So, maybe, it might be good to take Calcitriol.

Either that or an ice cream sundae each night before dialysis.   

[kamalshah20]

Or a glass full of cola perhaps!

[del]

Nocturnal dialysis will help lower you phosphorus. My husband has to make sure he eats lots of high phos food since starting nocturnal.  He just finished a glas of cola!!
What a difference from conventional when he had to almost eliminate high phos foods plus take binders!! He takes rocaltrol for vitamin D and to lower PTH.  He takes 0.25 one day and 0.5 the next day.  His PTH has dropped a lot since starting nocturnal.  He does 5 nights a week on home nocturnal for 7 or 8 hrs a night.

[HubbysPartner]

My husband takes calcitriol orally once a day and has zemplar given three times a week during treatment.  His phosphorus and calcium levels are good as well as his PTH.  He doesn't have to worry too much about high phosphorus foods and only needs to take a binder if his meal is really high in phosphorus.  I'm hoping things continue that way.

[Charlie B53]

Reported ad posting to Mod.

[SooMK]

Thanks Charlie. I was too quick and reported it again before seeing your post.