Alphadol
✅ Boosts calcium absorption
✅ Treats vitamin D deficiency
✅ Strengthens bones
✅ Supports dental health
✅ Improves muscle function
Alphadol contains Alfacalcidol.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Quick Answer
Alphadol (alfacalcidol 0.25 / 1 mcg soft gelatin capsule) is alfacalcidol — a pre-activated vitamin D analogue used in chronic kidney disease, hypoparathyroidism, and renal osteodystrophy where the kidney cannot perform 1-α-hydroxylation of cholecalciferol.
- Alfacalcidol — bypasses the renal activation step that fails in CKD
- Soft gelatin capsule, typical dose 0.25–1 mcg/day
- Specialist-supervised in CKD, hypoparathyroidism, vitamin D-resistant rickets
- WHO-GMP certified manufacturer
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What is Alphadol?
Alphadol is alfacalcidol (1-α-hydroxycholecalciferol) — a synthetic vitamin D analogue that is already 1-α-hydroxylated. After absorption it requires only a single liver hydroxylation step to become 1,25-dihydroxyvitamin D (calcitriol), the biologically active form. This bypasses the kidney 1-α-hydroxylation step that fails in chronic kidney disease.
When alfacalcidol is the right choice
For everyone with intact kidney function, plain cholecalciferol (vitamin D3) is preferred — it is cheaper, has a much wider safety margin, and the body regulates its activation tightly. Alfacalcidol is reserved for patients in whom the kidney cannot complete 1-α-hydroxylation:
- Chronic kidney disease (CKD) stages 4–5 with secondary hyperparathyroidism
- Dialysis-related renal osteodystrophy
- Hypoparathyroidism (post-thyroidectomy, autoimmune)
- Pseudohypoparathyroidism
- Vitamin D-resistant rickets (X-linked hypophosphataemic rickets, vitamin D-dependent rickets type 1)
- Severe hepatic disease with impaired 25-hydroxylation (occasionally)
| Indication | Starting dose | Titration | Monitoring |
|---|---|---|---|
| CKD stage 4–5 (pre-dialysis) | 0.25 mcg daily | Titrate to PTH target by 0.25 mcg every 4–8 weeks | Calcium, phosphate, PTH every 4–8 weeks during titration; then quarterly |
| Haemodialysis (renal osteodystrophy) | 0.25–0.5 mcg on dialysis days | Titrate to PTH | As above |
| Hypoparathyroidism | 1–3 mcg daily | Titrate to corrected calcium 8–9 mg/dl (low-normal) | Weekly during titration; then monthly |
| Vitamin D-resistant rickets | 0.5–3 mcg daily (paediatric specialist) | Specialist-titrated | Specialist-titrated |
| Severe hepatic 25-hydroxylation defect | 0.5–1 mcg daily | Titrate to clinical response | As CKD |
Because alfacalcidol bypasses the regulated kidney activation step, the body cannot down-regulate it — hypercalcaemia is the most common adverse effect at supra-therapeutic doses. Symptoms (anorexia, nausea, polyuria, confusion, AKI) are easy to miss in CKD patients who already feel unwell. Check serum calcium and phosphate weekly during titration and quarterly on stable dose. Stop and recheck if calcium > 10.5 mg/dl (2.6 mmol/l).
Side effects
- Hypercalcaemia — the dominant dose-limiting effect
- Hyperphosphataemia — common in CKD; combine with phosphate binder
- Soft tissue calcification at sustained high calcium-phosphate product
- Pruritus, nausea, headache — usually dose-related
Drug interactions
- Thiazide diuretics — potentiate hypercalcaemia
- Calcium-containing phosphate binders — additive hypercalcaemia risk; non-calcium binders (sevelamer, lanthanum) often preferred when alfacalcidol dose is high
- Magnesium-containing antacids — risk of hypermagnesaemia in CKD
- Digoxin — hypercalcaemia amplifies toxicity
- Cholestyramine — reduces absorption; separate by 4 hours
Contraindications
- Hypercalcaemia from any cause
- Hypervitaminosis D
- Active metastatic calcification
- Hyperphosphataemia not yet controlled by phosphate binder (relative)
Storage
Store below 25°C in original packaging, protect from light.
Frequently Asked Questions
Should I use Alphadol or Calcirol?
For normal kidney function, use Calcirol (cholecalciferol) — it is safer, cheaper, and the body regulates its activation. Alfacalcidol (Alphadol) is for patients whose kidneys cannot perform 1-α-hydroxylation: CKD stages 4–5, dialysis, hypoparathyroidism, pseudohypoparathyroidism, and certain rickets.
How is alfacalcidol different from calcitriol?
Calcitriol is fully active 1,25-dihydroxyvitamin D — needs no further activation. Alfacalcidol is 1-α-hydroxyvitamin D — needs only liver 25-hydroxylation, which is preserved in CKD. The difference is largely cost and dosing intervals; clinically they are similar at equivalent doses (alfacalcidol ∼ 1.5× calcitriol dose).
How quickly does it work?
Onset is hours; full effect by 1–2 weeks. Half-life is short (~5–8 hours), so dose changes show up quickly — calcium can normalise (or rise into hypercalcaemia) within days.
Why monitor calcium so often?
Because alfacalcidol bypasses the regulated kidney step, hypercalcaemia is easy to provoke, especially with concurrent calcium-containing phosphate binders. Weekly calcium during titration is the safest way to find the dose that controls PTH without pushing calcium high.
Can I stop my calcium supplement?
Discuss with your nephrologist. In dialysis patients on alfacalcidol, calcium-containing binders are often replaced by non-calcium binders (sevelamer, lanthanum) to avoid additive hypercalcaemia.
Will I still need cholecalciferol (vitamin D3)?
Sometimes yes — nutritional vitamin D status (25-OH-D) is separate from calcitriol activity. Many guidelines recommend keeping 25-OH-D > 30 ng/ml even in CKD patients on alfacalcidol, because of vitamin D’s non-skeletal roles. Your nephrologist will decide.
Is alfacalcidol safe in pregnancy?
Used in pregnancy when needed for hypoparathyroidism or severe CKD under specialist guidance. Vitamin D requirements rise in pregnancy and the substrate-product chain still works; doses often need adjustment.
How does it interact with bisphosphonates?
Compatible. In CKD-related secondary hyperparathyroidism, alfacalcidol controls PTH while bisphosphonate (where renal function permits) protects bone. Watch for hypocalcaemia after bisphosphonate; alfacalcidol helps prevent this.
Can I take it on dialysis days only?
Yes — some haemodialysis protocols use thrice-weekly intermittent dosing on dialysis days (e.g. 0.25–0.5 mcg three times a week) instead of daily. Both work; choice depends on PTH and calcium response.
What if I miss a dose?
Take it when you remember if it is the same day. Skip if it is the next day — do not double up. The short half-life means missed doses don’t produce dramatic swings, but consistent dosing improves PTH control.
Other Vitamins & Minerals
- Calcirol — cholecalciferol 60,000 IU sachet
- Arachitol 6L Injection — cholecalciferol 6,00,000 IU IM depot
- Alphadol — alfacalcidol for CKD-related deficiency
- Cipcal — calcium carbonate + vitamin D
- Topcal M — calcium + magnesium + vitamin D
- Osteofos — alendronic acid for osteoporosis
Medical Disclaimer
More options in Vitamins and Minerals
Ranked by recent MedsBase order volume — what other customers in this category are picking.
| Strength | 0.25 mg |
|---|---|
| Quantity | 30 Capsule/s, 60 Capsule/s, 90 Capsule/s, 180 Capsule/s |
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Alphadol
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