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Further, calcitriol is involved sustanonĀ in the growth and differentiation of bone cells and in maintaining the neuromuscular transmission striated muscles functioning to modulate immune responses. The mechanism of action of calcitriol related to interaction with specific receptors localized in the nucleus (Genomic mechanism), as well as on the plasma membrane of target cells (nongenomic mechanism). The drug is accompanied by normalization of decreased calcium absorption in the intestine, its reabsorption in the kidney and an increase in the plasma concentration, the suppression of secretion of parathyroid hormone. In its application reduces the pain in the bones and muscles, improves mineralization of the skeleton.

After intake of rapidly absorbed from the intestine. The maximum serum concentration reached in 4-6 hours. In the blood, it binds to specific plasma proteins. It penetrates through the placental barrier and is excreted in breast milk. The biotransformation of the drug proceeds with the formation of a number of metabolites with varying degrees pronounced activity of vitamin D3. The half-life is 3-6 hours, but due to the high lipophilicity of the drug and its metabolites can partially accumulate in adipose tissue in connection with which the pharmacological effect can persist up to 3-5 days. Excreted in the bile and partially subjected to enterohepatic recirculation. In patients on hemodialysis, the serum concentration is reduced, and its maximum concentration is reached after a longer period of time.

Renal osteodystrophy in patients with chronic renal failure (especially in patients on hemodialysis). Postmenopausal, senile osteoporosis and steroid.Postoperative hypoparathyroidism, idiopathic hypoparathyroidism and pseudohypoparathyreosis.

Diseases accompanied by hypercalcemia and hyperphosphatemia, hypervitaminosis D.
Hypersensitivity to the drug, as well as other preparations of vitamin D. The period of lactation – Children’s age

Be wary drug used in cardiac and renal failure, phosphate nephrolithiasis, sarcoidosis, and others. Granulomatosis. Elderly patients for the prevention of complications giperkaltsemicheskih require particularly careful selection sustanonĀ of individual dosage.

Dosage and administration:
The capsules are taken orally with water. Renal osteodystrophy (dialysis patients) in patients with normal or slightly reduced level of calcium in the blood serum of a drug typically used at a dose of 0.25 mg / day. every other day. In the absence of a satisfactory effect of the dose can be increased to 0.25 mg at intervals of 2-4 weeks. As a rule, the dosage of 0.5-1 mg per day provides the desired clinical effect.Postmenopausal, senile osteoporosis and steroid According 0.25 mg 2 times a day, for a long time. Hypoparathyroidism Treatment starts with a dose of 0.25 mg once daily in the morning. If necessary, the dose may be increased at intervals of 2-4 weeks, or 0.25 mcg to 0.5-1 mcg / day

Side effects
The product is well tolerated and rarely causes side effects. In some cases, when receiving Osteotriola can occur hypercalcemia, hypercalciuria, symptoms of which include nausea, vomiting, constipation, abdominal pain, anorexia, lethargy, headache, drowsiness and apathy. In patients with normal renal function, chronic hypercalcemia may increase the serum creatinine.
The appearance of these effects suggests excess dosing. The probability of occurrence of hypercalcemia is higher in patients with renal failure, hyperparathyroidism or hemodialysis. In very rare cases (especially in the presence of hypercalcemia and hyperphosphatemia) can develop soft tissue calcifications.

Overdose Symptoms of acute intoxication: anorexia, headache, vomiting, and constipation. Symptoms of chronic poisoning: dystrophy (weakness, weight loss, numbness, fever with thirst, polyuria, dehydration, apathy, urinary tract infection, calcification foci in the internal organs. Treatment In accidental overdose: . conduct gastric lavage, or administration of emetics to prevent further absorption of the drug with the development of hypercalcemia therapy sustanon must stop, assign a diet low in calcium and keep the patient under medical supervision to normalize the calcium concentration in the blood plasma after this therapy can be resumed either. using a lower dose, or the same, but at higher dosing intervals. in the case of acute hypercalcemia must hydration in order to open the patient’s urine output by chance. by increasing bone resorption calcitonin promotes reduction in serum calcium. shop steroids bharat serums