Pharmacokinetics and biologic effects of calcitriol in normal humans

The dose response and pharmacokinetics of orally administered calcitriol were investigated in normal humans. In one protocol, six volunteers received calcitriol 0.25 micrograms twice a day, 0.5 micrograms daily, and 0.5 micrograms twice a day, in successive weeks. Peak plasma levels of 1,25(OH)2D occurred 4 to 8 hours after ingestion of a single dose of 0.5 micrograms, with a return to baseline within 24 hours. The 8:00 AM calcitriol plasma levels were raised only when the drug was given twice daily. Urinary calcium excretion (UCa) was significantly increased from 199 +/- 19 mg/24 hr during the control period to similar levels of 302 +/- 26 mg/24 hr after 0.25 microgram twice a day and 284 +/- 31 mg/24 hr after 0.50 microgram daily. With 0.50 microgram twice a day, UCa was 417 +/- 36 mg/24 hr, a value greater than after the lower doses (p less than 0.05). In another protocol, fourteen volunteers received calcitriol 0.25 microgram, 0.5 microgram, and 1.0 microgram twice a day each for 14 days with intervening control periods of 2 weeks. A dose-related response in urinary calcium/creatinine excretion occurred. Thus, UCa (milligrams calcium per milligram creatinine) increased with calcitriol from 0.13 +/- 0.014 mg to 0.15 +/- 0.018 mg with 0.25 microgram twice a day, from 0.13 +/- 0.010 mg to 0.22 +/- 0.022 mg with 0.5 microgram twice a day, and from 0.12 +/- 0.012 mg to 0.23 +/- 0.012 mg with 1 microgram twice a day (p less than 0.05 with 0.25 microgram, p less than 0.01 with 0.5 and 1 microgram twice a day).(ABSTRACT TRUNCATED AT 250 WORDS)