Calcitriol

Introduction

Written by Julz Richterman, PharmD, MBA, BCGP
Medically reviewed by Amber Watson, PharmD
Updated on October 5, 2023

Calcitriol (kal si TRYE ole) is a generic medication prescribed for low calcium level in certain people. It’s also prescribed for plaque psoriasis in adults and some children. Calcitriol belongs to a group of drugs called vitamin D analogs.

The approved uses differ based on the form of calcitriol your doctor prescribes.

This article doesn’t provide coupons for all forms of calcitriol. To find coupons for calcitriol topical ointment, see this article.

Side effects of calcitriol

Calcitriol may cause mild or serious side effects. More common mild side effects of calcitriol and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about calcitriol’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for calcitriol listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of calcitriol are listed below. These side effects may differ based on the form of calcitriol you use.

This article doesn’t include all possible mild side effects of the drug. To learn more about calcitriol’s side effects based on the form, refer to the prescribing information for calcitriol listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Calcitriol oral capsule’s mild side effects include:

• mildly high calcium level in your blood and urine
• muscle or bone pain
• confusion or weakness
• upset stomach, nausea, or vomiting
• mild allergic reaction*

Calcitriol topical† ointment’s mild side effects include:

• skin discomfort, such as a painful or burning sensation where the ointment is applied
• itchiness
• mildly high calcium level in your blood and urine
• worsened psoriasis
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for calcitriol” section.
† Topical products are applied to your skin.

Serious side effects

Serious side effects of calcitriol are listed below. These side effects may differ based on the form of calcitriol you use.

This article doesn’t include all possible serious side effects of the drug. To learn more about calcitriol’s side effects based on the form, refer to the prescribing information for calcitriol listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, calcitriol’s serious side effects include:

• severely high calcium level, which may require emergency attention
• calcification (calcium buildup in parts of your body that leads it to harden)
• decreased kidney function
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for calcitriol” section.

Uses of calcitriol

The Food and Drug Administration (FDA) approves prescription drugs such as calcitriol for certain conditions. Approved uses for calcitriol are described below. These uses differ based on the form of calcitriol prescribed.

Use for low calcium levels

Doctors may prescribe calcitriol oral capsule, oral liquid solution, or injection* for treating low calcium level in people who are having dialysis. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

Low calcium level can occur due to kidney disease. If you’re having dialysis, you likely have kidney failure. Dialysis is a procedure that uses a machine, instead of your kidneys, to filter and purify your blood. Kidney failure causes low calcium levels in your body because your kidneys are unable to activate vitamin D as usual. Your body uses vitamin D to absorb (take in) calcium. Calcium is needed for bone and muscle health, and different processes in your body.

Calcitriol is the active form of vitamin D. So your kidneys do not need to activate vitamin D for it to help increase your calcium levels.

* Calcitrol injection is given into your vein.

Use for high parathyroid hormone levels

Doctors may prescribe calcitriol oral capsule or oral liquid solution to treat high parathyroid hormone (PTH) levels in people with chronic kidney disease. It’s used for this purpose in adults and children ages 1 year and older who are not yet having dialysis. It’s usually prescribed as a long-term treatment.

Your parathyroid glands release PTH when your calcium level is low. PTH tells your kidneys to activate more vitamin D, which helps increase calcium levels. Your body needs calcium for bone and muscle health, and different processes in your body.

But chronic kidney disease may prevent your kidneys from reacting as well to PTH. As a result, vitamin D and calcium levels will remain low. This causes your parathyroid glands to become overactive and continue making PTH. This is what causes high PTH levels.

Calcitriol is the active form of vitamin D, which helps increase your calcium levels. Once your calcium levels increase, your parathyroid glands will stop making PTH.

Use for plaque psoriasis

Doctors may prescribe calcitriol topical ointment for treating plaque psoriasis. Topical products are applied to your skin. It’s used for this purpose in adults and children ages 2 years or older. It’s usually prescribed as a long-term treatment.

Psoriasis is an autoimmune disease that affects your skin. This means your immune system mistakenly identifies healthy skin cells in your body as possibly harmful. As a result, your immune system attacks them. Plaque psoriasis is a type of psoriasis that causes patches of skin to become:

• dry
• red or discolored
• itchy
• inflamed (swollen)
• flaky or scaly

Doctors may not prescribe calcitriol topical ointment in certain situations, such as for people with problems processing calcium.

Common questions about calcitriol

Below you’ll find answers to a few commonly asked questions about calcitriol.

Is calcitriol similar to cholecalciferol?

Yes, but they are not the same. Calcitriol is the active form of cholecalciferol. Cholecalciferol is a type of vitamin D. Specifically, it’s vitamin D3. When you take in cholecalciferol through sun exposure or diet, your body needs to activate it.

If you have decreased kidney function or are having dialysis, your body cannot activate cholecalciferol in the amount you need. So your doctor may prescribe you calcitriol, the active form of vitamin D. This helps increase calcium levels and decrease parathyroid hormone levels. For more details about the uses of calcitriol, see the “Uses of calcitriol” section.

Talk with your doctor or pharmacist if you have any questions about which form of vitamin D may be best for you.

What brand names are available for calcitriol?

Calcitriol is a generic medication. Available brand-name versions include:

• Rocaltrol, which is available as an oral capsule and oral liquid solution
• Vectical, which is available as a topical ointment that’s applied to your skin

Calcijex was the brand-name version of calcitriol injection.* But the brand-name version is no longer available.

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.

Talk with your doctor or pharmacist if you have any questions about generic and brand-name medications.

* Calcitriol injection is given into your vein.

How does calcitriol work? And how long does it take to start working?

Calcitriol is the active form of vitamin D. Vitamin D increases calcium levels by working in your:

• bones to release calcium
• intestines to absorb (take in) more calcium

Your parathyroid glands sense this increase in calcium. So they’ll stop releasing parathyroid hormone (PTH). If you have high PTH levels due to chronic kidney disease, they will likely decrease. If you have low calcium levels due to kidney disease, your calcium levels will increase. For details about the uses of calcitriol, see the “Uses of calcitriol” section.

Calcitriol oral capsule, oral liquid solution, and injection should start working within a day or two. But it may take several weeks for the effects to show on lab test results.

It’s unknown how calcitriol topical* ointment works. But it should start working within 4 weeks to treat plaque psoriasis.

If you’d like to know more about this, talk with your doctor or pharmacist.

* Topical products are applied to your skin.

Interactions and warnings for calcitriol

Below you’ll find information about calcitriol’s possible interactions and warnings.

Interactions of calcitriol

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Some forms of calcitriol have interactions, so ask your doctor to check for possible interactions before you take calcitriol. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs 
• vitamins, herbs, or supplements

Other forms of calcitriol don’t have any known interactions. But this doesn’t mean drug interactions with calcitriol won’t happen or be reported sometime. For instance, medications created at a later time could interact with these forms of calcitriol.

To learn about drug-condition interactions, see the “Warnings for calcitriol” section below.

Warnings for calcitriol

Calcitriol should be taken cautiously by certain people.

Calcitriol could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether calcitriol is a safe option for you. These warnings may differ based on the form of calcitriol you take.

Ask your doctor about specific warnings for calcitriol, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Calcitriol can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to calcitriol or any of its ingredients, your doctor will likely not prescribe calcitriol. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to calcitriol, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of calcitriol

If you take calcitriol by mouth or apply calcitriol on your skin, you should not take or apply more calcitriol than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much calcitriol, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and calcitriol

Information about calcitriol and pregnancy and breastfeeding is described below.

Calcitriol and pregnancy

There are risks to taking calcitriol during pregnancy. But there are also risks with having untreated low calcium level, high parathyroid hormone level, or plaque psoriasis while pregnant. (Keep in mind that calcitriol is used for treating these conditions.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about your treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take calcitriol during pregnancy.

Calcitriol and breastfeeding

Calcitriol should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with calcitriol.  

What to ask your doctor

Let your doctor know if you have questions about calcitriol or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Is it safe to take my other medications and supplements with calcitriol?
• What lab tests will I need during calcitriol treatment?
• Can I apply calcitriol topical ointment on my lips or face?

Resources

• Calcitriol capsule. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/36820cd0-7b30-4454-9005-09d71e1d5796/spl-doc
• Calcitriol injection. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/fe7ea4da-bda0-bb00-e053-6394a90a94e7/spl-doc
• Calcitriol ointment. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/cc344944-7dad-403e-bfd2-8c649e2fbfb0/spl-doc
• Calcitriol solution. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/3289b482-8733-484d-b1db-d7f4cdcd1ac2/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.