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The treatment of acute accidental overdosage of Rocaltrolcalcitriolshould consist of general supportive measuresIf drug ingestion is discovered within a relatively short timeinduction of emesis or gastric lavage may be of benefit in preventing further absorptionIf the drug has passed through the stomachthe administration of mineral oil may promote its fecal eliminationSerial serum electrolyte determinationsespecially calciumrate of urinary calcium excretionand assessment of electrocardiographic abnormalities due to hypercalcemia should be obtainedSuch monitoring is critical in patients receiving digitalisDiscontinuation of supplemental calcium and a low-calcium diet are also indicated in accidental overdosageDue to the relatively short duration of the pharmacological action of calcitriolfurther measures are probably unnecessaryShouldhoweverpersistent and markedly elevated serum calcium levels occurthere are a variety of therapeutic alternatives which may be considereddepending on the patient’s underlying condition.
The coadministration of phenytoin or phenobarbital will not affect plasma concentrations of calcitriolbut may reduce endogenous plasma levels of 25(OH)D 3 by accelerating metabolismSince blood level of calcitriol will be reducedhigher doses of Rocaltrolcalcitriolmay be necessary if these drugs are administered simultaneously.
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