Therapeutic Objective
Remediation of demineralization
Therapy recommendations
- Therapy recommendations depending on the indications:
- Rickets: cholecalciferol (vitamin D3);calcium substitution.
- Osteomalacia:
- Cholecalciferol (vitamin D3), orally or
- Vitamin D conversion disorders and hypophosphatemic osteomalacia: calcitriol, orally and calcium substitution.
- Hypophosphatemia (primarily remediation of the cause); if not causally treatable cause such as Fanconi syndrome: phosphate and calcitriol substitution.
- 1-Alpha-hydroxylase defect: calcitriol.
- Phosphate diabetes: phosphate, calcitriol
- Treatment of coincident osteoporosis after complete treatment of osteomalacia (see below osteoporosis).
- Prophylaxis: cholecalciferol (vitamin D3), fluoride.
Further notes
- In case of rickets after starting therapy after 3 to 4 weeks: Laboratory control of calcium or vitamin D to adjust the dose if necessary.
- Osteomalacia
- If necessary, parenteral administration of cholecalciferol in cases of gastrointestinal malabsorption or after bariatric surgery.
- Monitoring the success of therapy: determination of calcium, phosphate, parathyroid hormone and alkaline phosphatase. Furthermore, performance of osteodensitometry by means of dual X-ray absorptiometry (DXA, DEXA) for follow-up.
