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

Since Rocaltrolcalcitriolis believed to be the active hormone which exerts vitamin D activity in the bodyadverse effects arein generalsimilar to those encountered with excessive vitamin D intakeiehypercalcemia syndrome or calcium intoxicationdepending on the severity and duration of hypercalcemiasee WARNINGSBecause of the short biological half-life of calcitriolpharmacokinetic investigations have shown normalization of elevated serum calcium within a few days of treatment withdrawaliemuch faster than in treatment with . vitamin D 3 preparations.

Oral Rocaltrolcalcitriolmay normalize plasma ionized calcium in some uremic patientsyet fail to suppress parathyroid hyperfunctionIn these individuals with autonomous parathyroid hyperfunctionoral Rocaltrolcalcitriolmay be useful to maintain normocalcemiabut has not been shown to be adequate treatment for hyperparathyroidism.

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