Alfacalcidol 1microgram capsules
Requires a prescription from a doctor or prescriber
Alfacalcidol, or 1-alpha-hydroxycholecalciferol or 1-alpha-hydroxyvitamin D3, is a non-endogenous analogue of [vitamin D].[A234044] It plays an essential function in calcium homeostasis and bone metabolism.
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Safety monitoring data
Yellow Card reports
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
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Suspected adverse reactions reported for Alfacalcidol
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21 branded products available
MHRA licensed products
View all licensed products for Alfacalcidol on the MHRA register
AlfaD 1microgram capsules
One-Alpha 1microgram capsules
One-Alpha 1microgram capsules
Alfacalcidol 1microgram capsules
Alfacalcidol 1microgram capsules
Alfacalcidol 1microgram capsules
Alfacalcidol 1microgram capsules
Alfacalcidol 1microgram capsules
This is the NHS Drug Tariff indicative price used for reimbursement purposes. It may not reflect the price paid by patients or pharmacies.
View full Drug TariffSource: NHS Drug Tariff via NHSBSA. Derived from dm+d VMPP (Virtual Medicinal Product Pack) pricing data. Contains public sector information licensed under the Open Government Licence v3.0.
WHO defined daily dose (DDD)
1 microgram
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via NHS dm+d BNF mapping files. Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Clinical guidelines and formulary information
British National Formulary
Alfacalcidol
Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.
NICE clinical guidance(4)
Burosumab for treating X-linked hypophosphataemia in children and young people (HST8)
Etelcalcetide for treating secondary hyperparathyroidism (TA448)
Mitochondrial disorders in children: Co-enzyme Q10 (ES11)
Chronic kidney disease: assessment and management (NG203)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
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Supply & product information
Official product databases and supply status monitoring
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. emc (electronic medicines compendium) is operated by Datapharm Ltd. Shortage information sourced from NHS Specialist Pharmacy Service (SPS), sps.nhs.uk.
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF codes from NHS Business Services Authority (NHSBSA). ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
Not available
Mechanism
In conditions like chronic renal failure, renal bone disease, hypoparathyroidism…
Food interactions
1 warning
Human targets
3 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
[L33369]
Half-life
[L33284][L33369]
Protein binding
[L33369]
Metabolism
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Alfacalcidol is available in oral and intravenous formulations. In Canada, it is marketed as ONE-ALPHA, which manages hypocalcemia, secondary hyperparathyroidism, and osteodystrophy in adults with chronic renal failure.[L33284] In approving European countries, alfacalcidol is also indicated for managing nutritional and malabsorptive rickets and osteomalacia, vitamin D-dependent rickets and osteomalacia, and hypophosphataemic vitamin D resistant rickets and osteomalacia.[L33364][L33369]
[L33284]
Alfacalcidol is indicated in the management of nutritional and malabsorptive rickets and osteomalacia, vitamin D-dependent rickets and osteomalacia, and hypophosphataemic vitamin D resistant rickets and osteomalacia.
[L33364][L33369]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 156 interactions
Oral LD50 in rats ranges from 340 to 720 mcg/kg.
[L33284]
In case of an acute accidental overdose following oral administration, emesis or gastric lavage can be induced to prevent further drug absorption. Mineral oil may be used to promote fecal drug elimination in instances where the drug was already absorbed in the stomach.
[L33284]
Alfacalcidol overdose can lead to hypercalcemia, hypercalciuria, and hyperphosphatemia. Similarly, a high intake of calcium and phosphate concurrently with a therapeutic dose of alfacalcidol can result in those conditions.
[L33284]
Hypercalcemia most commonly presents with headache, weakness, hypertension, somnolence, dizziness, sweating, anorexia, nausea, vomiting, diarrhea, constipation, polyuria, polydipsia and muscle and bone pain, and metallic taste.
[L33369]
Hypercalcemia should be responded to with discontinuation of alfacalcidol, a low calcium diet and withdrawal of calcium supplements.
[L33284]
Prolonged hypercalcemia can lead to nephrocalcinosis, nephrolithiasis, and reduced kidney function.
In cases of severe hypercalcemia, general supportive measures are recommended, which may include forced diuresis and close monitoring of renal function, electrolytes, and electrocardiographs. Monitoring for abnormalities is especially critical in patients receiving digitalis glycosides. Management with glucocorticosteroids, loop diuretics, bisphosphonates, and calcitonin, as well as hemodialysis with low calcium content, may be considered.
[L33369]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[L33369]
[L33284][L33369]
[L33369]
[L33369]
Proteins and enzymes this drug interacts with in the body
PMID:10678179 PMID:15728261 PMID:16913708 PMID:28698609 PMID:37478846
Enters the nucleus upon vitamin D3 binding where it forms heterodimers with the retinoid X receptor/RXR .
PMID:28698609
The VDR-RXR heterodimers bind to specific response elements on DNA and activate the transcription of vitamin D3-responsive target genes .
PMID:28698609
Plays a central role in calcium homeostasis (By similarity). Also functions as a receptor for the secondary bile acid lithocholic acid (LCA) and its metabolites PMID:12016314 PMID:32354638
PMID:10518789 PMID:10566658 PMID:12050193 PMID:22862690 PMID:9486994
Has 1alpha-hydroxylase activity on vitamin D intermediates of the CYP24A1-mediated inactivation pathway .
PMID:10518789 PMID:22862690
Converts 24R,25-dihydroxyvitamin D3/secalciferol to 1-alpha,24,25-trihydroxyvitamin D3, an active ligand of VDR. Also active on 25-hydroxyvitamin D2 .
PMID:10518789
Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via FDXR/adrenodoxin reductase and FDX1/adrenodoxin PMID:22862690
PMID:10874028 PMID:11162439 PMID:11915042 PMID:37478846
Forms homo- or heterodimers with retinoic acid receptors (RARs) and binds to target response elements in response to their ligands, all-trans or 9-cis retinoic acid, to regulate gene expression in various biological processes .
PMID:10195690 PMID:11162439 PMID:11915042 PMID:16107141 PMID:17761950 PMID:18800767 PMID:19167885 PMID:28167758 PMID:37478846
The RAR/RXR heterodimers bind to the retinoic acid response elements (RARE) composed of tandem 5'-AGGTCA-3' sites known as DR1-DR5 to regulate transcription .
PMID:10195690 PMID:11162439 PMID:11915042 PMID:17761950 PMID:28167758
The high affinity ligand for retinoid X receptors (RXRs) is 9-cis retinoic acid .
PMID:1310260
In the absence of ligand, the RXR-RAR heterodimers associate with a multiprotein complex containing transcription corepressors that induce histone deacetylation, chromatin condensation and transcriptional suppression .
PMID:20215566
On ligand binding, the corepressors dissociate from the receptors and coactivators are recruited leading to transcriptional activation .
PMID:20215566 PMID:37478846 PMID:9267036
Serves as a common heterodimeric partner for a number of nuclear receptors, such as RARA, RARB and PPARA .
PMID:10195690 PMID:11915042 PMID:28167758 PMID:29021580
The RXRA/RARB heterodimer can act as a transcriptional repressor or transcriptional activator, depending on the RARE DNA element context .
PMID:29021580
The RXRA/PPARA heterodimer is required for PPARA transcriptional activity on fatty acid oxidation genes such as ACOX1 and the P450 system genes .
PMID:10195690
Together with RARA, positively regulates microRNA-10a expression, thereby inhibiting the GATA6/VCAM1 signaling response to pulsatile shear stress in vascular endothelial cells .
PMID:28167758
Acts as an enhancer of RARA binding to RARE DNA element .
PMID:28167758
May facilitate the nuclear import of heterodimerization partners such as VDR and NR4A1 .
PMID:12145331 PMID:15509776
Promotes myelin debris phagocytosis and remyelination by macrophages .
PMID:26463675
Plays a role in the attenuation of the innate immune system in response to viral infections, possibly by negatively regulating the transcription of antiviral genes such as type I IFN genes .
PMID:25417649
Involved in the regulation of calcium signaling by repressing ITPR2 gene expression, thereby controlling cellular senescence PMID:30216632
Proteins that carry this drug through the body
ATC A11CC03
ATC M05BB06
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Alfacalcidol
Additional database identifiers
Drugs Product Database (DPD)
4892
ChemSpider
4445376
PDB
M9B
ZINC
ZINC000012484965
HUGO Gene Nomenclature Committee (HGNC)
HGNC:12679
GenAtlas
VDR
GeneCards
VDR
GenBank Gene Database
J03258
GenBank Protein Database
340203
Guide to Pharmacology
605
UniProt Accession
VDR_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2606
GenAtlas
CYP27B1
GeneCards
CYP27B1
GenBank Gene Database
AF027152
GenBank Protein Database
2612976
Guide to Pharmacology
1370
UniProt Accession
CP27B_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:10477
GenAtlas
RXRA
GeneCards
RXRA
GenBank Gene Database
X52773
GenBank Protein Database
35885
Guide to Pharmacology
610
UniProt Accession
RXRA_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4187
GenAtlas
GC
GeneCards
GC
GenBank Gene Database
L10641
GenBank Protein Database
639896
UniProt Accession
VTDB_HUMAN
UniProt Accession
V9H1D9_HUMAN
International reference pricing
Reference pricing from DrugBank. Prices are indicative and may not reflect current UK costs.
Source: DrugBank. Used under CC BY-NC 4.0 academic licence for non-commercial purposes.
DrugBank citations
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