Bon-One 0.25mcg Tablet

Bon-One 0.25mcg Tablet contains alfacalcidol 0.25 micrograms per tablet. Alfacalcidol (1α-hydroxyvitamin D3, also written 1-alpha-hydroxycholecalciferol) is a synthetic vitamin D analogue, which is different from the plain vitamin D3 (cholecalciferol) found in everyday vitamin D products. Ordinary vitamin D3 has to be activated in both the liver and the kidneys, whereas alfacalcidol already carries the 1-alpha hydroxyl group that the kidneys normally add, so it only needs one conversion step in the liver to become calcitriol, the active hormonal form of vitamin D.

Because it bypasses the kidney activation step, alfacalcidol is used under medical supervision in conditions where the body cannot properly activate vitamin D or regulate calcium, such as bone and calcium disorders linked to reduced kidney function or underactive parathyroid glands. Calcitriol increases the absorption of calcium and phosphate from the gut, so even small amounts of alfacalcidol have a strong effect on blood calcium levels. For this reason the dose is decided by a doctor for each person and is usually adjusted according to regular blood tests.

Each Bon-One tablet is taken by mouth and the 0.25mcg strength allows the doctor to make small, gradual dose adjustments. It is not a general vitamin D product and should not be taken as a substitute for a regular vitamin D supplement or in addition to one without medical advice. Please refer to the product label and packaging for the full list of inactive ingredients and the pack size supplied.

Take Bon-One 0.25mcg Tablet exactly as instructed by your doctor. Swallow the tablet with a glass of water, preferably after a meal, and try to take it at the same time each day so it is easier to remember.

Do not change your dose, stop taking the tablets or start other vitamin D or calcium products on your own. Your doctor will usually arrange blood tests to check your calcium and phosphate levels, especially at the start of treatment and after any dose change, so keep all follow-up appointments.

The dose of alfacalcidol is individual and must follow your doctor’s instructions. Doctors usually start with a low dose and adjust it in small steps according to blood calcium, phosphate and other test results, and the dose needed can differ greatly between adults, older adults and children.

There is no standard self-selected dose for this product, so do not use the tablet strength alone to decide how much to take. If you miss a dose, take it when you remember unless it is almost time for the next one; do not take a double dose to make up for a missed tablet. If you think you have taken too much, contact your doctor or the nearest emergency department, because excess alfacalcidol can raise blood calcium to unsafe levels.

• Store according to the instructions on the product label, in a cool, dry place away from direct sunlight, heat and moisture. Keep the tablets in their original packaging until it is time to take them.
• Keep out of the sight and reach of children, as accidental swallowing by a child can cause high calcium levels.

• Common: High blood calcium (hypercalcaemia) or high blood phosphate, which may show up as nausea, thirst, passing more urine, tiredness, weakness, muscle or bone pain, or confusion.
• Common: Abdominal pain or discomfort, skin rash and itching.
• Uncommon: Headache, nausea, vomiting, diarrhoea, constipation, muscle pain and general tiredness or weakness.
• Uncommon: Increased calcium in the urine, kidney stones or calcium deposits in the kidneys or other tissues.
• Rare: Dizziness.
• Serious: Worsening kidney function, confusion, hives or other allergic reactions. Seek medical attention promptly if these occur.

• Known allergy to alfacalcidol or to any of the other ingredients in the tablet.
• High blood calcium levels (hypercalcaemia).
• Metastatic calcification (abnormal calcium deposits in body tissues).
• Use in pregnancy is generally not recommended unless a doctor decides it is clearly needed after careful evaluation.

• Other vitamin D products and vitamin D analogues (such as cholecalciferol, calcitriol or multivitamins with vitamin D): increase the risk of high calcium and should not be combined without a doctor’s advice.
• Calcium supplements and thiazide diuretics (e.g. hydrochlorothiazide): may increase the risk of high blood calcium; calcium levels should be monitored.
• Digoxin and other digitalis medicines: high calcium levels increase the risk of irregular heartbeat.
• Magnesium-containing antacids or laxatives: alfacalcidol may increase magnesium absorption, raising the risk of high magnesium levels, especially in kidney disease.
• Aluminium-containing products (e.g. aluminium hydroxide, sucralfate): may raise aluminium levels in the blood.
• Bile acid sequestrants (e.g. cholestyramine): may reduce absorption; take alfacalcidol at least 1 hour before or 4–6 hours after them.
• Certain anticonvulsants (e.g. phenytoin, carbamazepine, phenobarbital, primidone): may speed up vitamin D breakdown so dose adjustment may be needed.
• Food: large amounts of calcium-fortified foods or high-dose calcium intake should be discussed with your doctor, as they can add to the effect on blood calcium.

• Take the tablet at the same time every day and follow the exact dose your doctor has set.
• Keep your scheduled blood tests, as they guide safe dose adjustments.
• Learn the signs of high calcium, such as nausea, excessive thirst, frequent urination, confusion or muscle weakness, and report them early.
• Check the labels of multivitamins, calcium products and antacids before buying them, and avoid extra vitamin D unless your doctor approves.
• Tell every doctor, dentist and pharmacist you see that you are taking alfacalcidol.
• Drink adequate fluids each day unless you have been advised to restrict fluids.

Precautions: Alfacalcidol has a strong effect on blood calcium and phosphate, so it should only be taken under medical supervision with regular blood tests, particularly in children, people with kidney disease and anyone on higher doses. Extra care is needed in people with kidney stones, sarcoidosis or other granulomatous diseases, calcium deposits in the lungs, liver disease or heart conditions treated with digoxin. Pregnancy is generally a reason to avoid this product unless a doctor decides otherwise, and women who could become pregnant should discuss contraception with their doctor. During breastfeeding, active vitamin D may pass into breast milk, so the baby may need to be monitored for high calcium.

When to See a Doctor or Pharmacist: Contact your doctor promptly if you develop persistent nausea or vomiting, loss of appetite, constipation, excessive thirst, passing large amounts of urine, unusual tiredness, muscle weakness, bone pain, confusion, irregular heartbeat, flank pain or a skin rash. Speak to your doctor or pharmacist before starting any new medicine, antacid, calcium product or vitamin D-containing supplement while taking Bon-One.