Alternative Names for Oral 1-Alpha Hydroxy-Cholecalciferol
Oral 1-alpha hydroxy-cholecalciferol is also known as alfacalcidol. 1, 2
Primary Nomenclature
The compound 1-alpha hydroxycholecalciferol has several interchangeable names used in clinical practice and medical literature:
- Alfacalcidol - This is the most commonly used generic name in clinical practice, particularly in Europe 1, 2
- 1α-hydroxyvitamin D3 - The systematic chemical nomenclature 2, 3
- 1α(OH)D3 - The abbreviated chemical notation 3
Mechanism and Clinical Context
Alfacalcidol functions as a prodrug that requires only 25-hydroxylation in the liver to be converted into the active hormone calcitriol (1,25-dihydroxyvitamin D3). 2 This distinguishes it from native vitamin D3 (cholecalciferol), which requires both 25-hydroxylation in the liver and 1α-hydroxylation in the kidney to become active. 2
The key advantage of alfacalcidol is that it bypasses the renal 1α-hydroxylase step, making it particularly valuable in patients with chronic kidney disease who have impaired renal hydroxylation capacity. 4
Clinical Applications
Alfacalcidol has been widely used since 1981 for multiple indications:
- Treatment of hypocalcemia 2
- Management of chronic renal failure and secondary hyperparathyroidism 1, 2, 3
- Treatment of hypoparathyroidism 2
- Management of osteoporosis 2, 4
- Treatment of X-linked hypophosphataemia (in combination with phosphate supplements) 1
Important Distinction from Related Compounds
It is critical not to confuse alfacalcidol with:
- Calcitriol (1,25-dihydroxyvitamin D3) - the fully active hormone that alfacalcidol converts into 1, 5
- Doxercalciferol (1α-hydroxyvitamin D2) - a similar prodrug derived from vitamin D2 rather than D3 2, 6
- Cholecalciferol (vitamin D3) - the native nutritional form requiring both hepatic and renal hydroxylation 1