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An abrupt increase in calcium intake as a result of changes in diete.gincreased consumption of dairy productsor uncontrolled intake of calcium preparations may trigger hypercalcaemiaPatients and their families should be advised that strict adherence to the prescribed diet is mandatory and they should be instructed on how to recognise the symptoms of hypercalcaemia.

Rocaltrolcalcitriolshould not be given to patients with hypercalcemia or evidence of vitamin D toxicityUse of Rocaltrolcalcitriolin patients with known hypersensitivity to Rocaltrolcalcitriolor drugs of the same classor any of the inactive ingredients is contraindicated.

Bile acid sequestrants including cholestyramine and sevelamer can reduce intestinal absorption of fat-soluble vitamins and therefore may impair intestinal absorption of calcitriol.

Rocaltrolcalcitriolis the most potent metabolite of vitamin D availableThe administration of Rocaltrolcalcitriolto patients in excess of their daily requirements can cause hypercalcemiahypercalciuriaand hyperphosphatemiaThereforepharmacologic doses of vitamin D and its derivatives should be withheld during Rocaltrolcalcitrioltreatment to avoid possible additive effects and hypercalcemiaIf treatment is switched from ergocalciferolvitamin D 2to calcitriolit may take several months for the ergocalciferol level in the blood to return to the baseline valuesee OVERDOSAGE

Heart arrhythmiasCalcitriol increases the amount of calcium in the bloodstreamToo much calcium can interfere with the regular rhythm of the heartIf you have irregular heartbeatarrhythmiadiscuss with your doctor how this medication may affect your medical conditionhow your medical condition may affect the dosing and effectiveness of this medicationand whether any special monitoring is needed.

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