Why is Rocaltrol prescribed?
Rocaltrol is a synthetic form of vitamin D used to treat people on dialysis who have hypocalcemia (abnormally low blood calcium levels) and resulting bone damage. Rocaltrol is also prescribed to treat low blood calcium levels in people who have hypoparathyroidism (decreased functioning of the parathyroid glands). When functioning correctly, these glands help control the level of calcium in the blood.
Rocaltrol is also prescribed for hyperparathyroidism (increased functioning of the parathyroid glands) and resulting bone disorders in people with kidney disease who are not yet on dialysis.
Most important fact about Rocaltrol
While you are taking Rocaltrol, your doctor may want you to follow a special diet or take calcium supplements. This is an important part of your therapy. On the other hand, too high a calcium level can be harmful. If you are already taking any medications containing calcium or calcium supplements, make sure you doctor knows about it.
How should you take Rocaltrol?
Be sure to get enough fluids and avoid dehydration while taking Rocaltrol.
--If you miss a dose...
If you take 1 dose every other day, and you remember before the next day, take the forgotten dose immediately, then go back to your regular schedule. If you do not remember until the next day, take the dose immediately, skip a day, then go back to your regular schedule.
If you take 1 dose every day, take it as soon as you remember. Then go back to your regular schedule. If you do not remember until the next day, skip the dose you missed and go back to your regular schedule.
If you take Rocaltrol more than once a day, take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.
Do not take 2 doses at once.
--Storage instructions...
Keep capsules and oral solution away from heat and light.
What side effects may occur?
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Rocaltrol.
• Side effects occurring early may include:
Bone pain, constipation, dry mouth, extreme sleepiness, headache, loss of appetite, metallic taste, muscle pain, nausea, vomiting, weakness
• Side effects occurring later may include:
Abnormal thirst, apathy, arrested growth, decreased sex drive, dehydration, elevated blood cholesterol levels, excessive urination, extremely high body temperature, high blood pressure, inflamed eyes, intolerance to light, irregular heartbeat, itchy skin, kidney problems, loss of appetite, nighttime urination, runny nose, sensory disturbances, urinary tract infections, wasting of muscles or other tissues, weight loss, yellowish skin
Excessive amounts of Vitamin D may cause abnormally high calcium levels in the blood.
Why should Rocaltrol not be prescribed?
You should not use Rocaltrol if you have high blood levels of calcium, or if you have vitamin D poisoning. You should also avoid Rocaltrol if it, or any similar drug, has given you an allergic reaction in the past.
Special warnings about Rocaltrol
You should not take additional doses of vitamin D while taking Rocaltrol. People who are on dialysis should not take antacids containing magnesium (such as Maalox) while taking Rocaltrol.
Your doctor will monitor your calcium levels while you are taking Rocaltrol because excessive calcium levels can be very dangerous. If this problem develops, your doctor will need to stop Rocaltrol therapy temporarily and prescribe a lower dose when treatment resumes.
While taking Rocaltrol, you should have an adequate daily intake of calcium (at least 600 milligrams a day), either from foods (such as milk and dairy products) or from a calcium supplement. Your doctor will estimate your daily calcium intake before you take Rocaltrol to see if you will require more calcium.
Possible food and drug interactions when taking Rocaltrol
If Rocaltrol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Rocaltrol with the following:

Antacids containing magnesium, such as Maalox
Calcium supplements
Cholestyramine (Questran)
Digitalis (Lanoxin)
Ketoconazole (Nizoral)
Phenobarbital
Phenytoin (Dilantin)
Steroid medications such as prednisone
Thiazide water pills such as Dyazide and HydroDIURIL
Vitamin D pills
Special information if you are pregnant or breastfeeding
The effects of Rocaltrol during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Pregnant women should use Rocaltrol only if the possible benefit outweighs any possible risk to the unborn baby.
Rocaltrol may appear in breast milk. Because it may affect a nursing infant, you should not use Rocaltrol while you are breastfeeding.
Recommended dosage
ADULTS
For People on Dialysis
The suggested beginning dose is 0.25 microgram daily. Your doctor may increase the dose by 0.25 microgram daily at 4 to 8 week intervals if needed. Most people on dialysis require a dose of 0.5 to 1 microgram a day.
People with normal or only slightly low blood calcium levels may find it helpful to take 0.25 microgram every other day.
For Low Calcium Levels Due to Hypoparathyroidism
The suggested beginning dose is 0.25 microgram daily, taken in the morning. Your doctor may increase the dose at 2 to 4 week intervals.
For most adults, regular doses ranging from 0.5 to 2 micrograms daily are effective.
For People Not Yet on Dialysis
The recommended starting dose is 0.25 microgram a day, increased to 0.5 microgram if necessary.
CHILDREN
For Low Calcium Levels Due to Hypoparathyroidism
The starting dose is 0.25 microgram, taken in the morning.
For most children 6 years and older, doses ranging from 0.5 to 2 micrograms per day are effective.
Children from 1 to 5 years old are usually given 0.25 to 0.75 microgram a day. Doses have not been established for hypoparathyroidism in infants under 1 year, or for pseudohypoparathyroidism (a special form of the disorder) in children under 6.
For Children not yet on Dialysis
The recommended starting dose for children 3 years and older is 0.25 microgram a day, increased to 0.5 microgram if necessary.
For children less than 3 years old, the daily starting dose is 10 to 15 nanograms per 2.2 pounds of body weight.
Overdosage
Any medication taken in excess can have serious consequences. Severe overdosage of Rocaltrol may cause serious effects, such as extremely high blood levels of calcium. Warning signs include the symptoms listed under early side effects. If you suspect an overdose, seek medical help immediately.