22-Oxacalcitriol
22-Oxacalcitriol[edit | edit source]
22-Oxacalcitriol (OCT) is a synthetic analog of calcitriol, the hormonally active form of vitamin D3. It is primarily used in the treatment of secondary hyperparathyroidism, particularly in patients with chronic kidney disease. Unlike calcitriol, 22-oxacalcitriol has a reduced effect on calcium metabolism, which makes it a valuable therapeutic agent in conditions where hypercalcemia is a concern.
Chemical Structure and Properties[edit | edit source]
22-Oxacalcitriol is chemically similar to calcitriol but with a modification at the 22nd carbon position, where an oxygen atom replaces a carbon atom. This structural change is responsible for its unique pharmacological properties.
- **IUPAC Name**: (1R,3S,5Z,7E,22E)-9,10-seco-22-oxacholesta-5,7,10(19),22-tetraene-1,3-diol
- **Molecular Formula**: C27H42O4
- **Molecular Weight**: 430.62 g/mol
Mechanism of Action[edit | edit source]
22-Oxacalcitriol acts on the vitamin D receptor (VDR) in target tissues, similar to calcitriol. It regulates the expression of genes involved in calcium and phosphate homeostasis. However, its reduced calcemic activity is due to its lower affinity for the VDR in the intestine and bone, which minimizes the risk of hypercalcemia.
Clinical Uses[edit | edit source]
22-Oxacalcitriol is primarily used in the management of secondary hyperparathyroidism in patients undergoing dialysis. It helps to suppress parathyroid hormone (PTH) levels without significantly increasing serum calcium and phosphate levels.
Pharmacokinetics[edit | edit source]
22-Oxacalcitriol is administered intravenously or orally. It has a rapid onset of action and a relatively short half-life, which allows for precise control over its effects. The drug is metabolized in the liver and excreted primarily in the bile.
Side Effects[edit | edit source]
The most common side effects of 22-oxacalcitriol include:
- Hypercalcemia (though less frequent than with calcitriol)
- Hyperphosphatemia
- Gastrointestinal disturbances
Research and Development[edit | edit source]
Ongoing research is exploring the potential of 22-oxacalcitriol in other conditions, such as osteoporosis and certain types of cancer, due to its ability to modulate cell proliferation and differentiation.
Also see[edit | edit source]
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