Because calcitriol also increases the intestinal absorption of phosphorous, hyperphosphatemia can occur in patients with renal failure and may further contribute to elevated serum creatinine levels, ectopic calcification, secondary hyperparathyroidism, and renal osteodystrophy. Hypercalciuria and nephrolithiasis have been confirmed in patients receiving systemic calcitriol treatment, and further laboratory abnormalities associated with late signs of hypercalcemia include elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and blood urea nitrogen (BUN) levels. Less than 1% of reported adverse reactions include hypertension, increased hematocrit, increased hemoglobin, drowsiness, hyperthermia, lymphocytosis, increased neutrophils, anorexia, constipation, and ophthalmic conditions, such as conjunctivitis and photophobia. Less than 10% of reported adverse reactions include headache, skin rash, polydipsia, nausea, abdominal pain, and urinary tract infection. Late signs of hypercalcemia include polyuria, polydipsia, cardiac arrhythmias, sensory disturbances, apathy, nephrocalcinosis, urinary tract infections, and hypertension.

Early signs of hypercalcemia include fatigue, weakness, nausea, vomiting, abdominal pain, constipation, diarrhea, vertigo, tinnitus, ataxia, arthralgia, and irritability.

Hypercalcemia is the most common adverse reaction reported in at least one-third of patients taking systemic calcitriol.

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