Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

doxercalciferol (Rx)Brand and Other Names:Hectorol

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 0.5mcg
  • 2.5mcg

injectable solution

  • 2mcg/mL
more...

Dialysis

Intial dose

  • 10 mcg PO 3 times/week at dialysis, may increase by 2.5 mcg/dose, no more than 20 mcg/dose 3 times/week OR
  • 4 mcg IV bolus 3 times/week following dialysis, may increase by 1-2 mcg/dose q8Weeks

Dose Modifications

  • If intact parathyroid hormone (iPTH) <100 pg/mL, withhold for 1 week; then reinitiate at reduced dose of at least 2.5 mcg PO lower than last dose or at least 1 mcg IV lower than last dose
  • Reduce dose or stop the drug if Ca x P product >75 mg²dL²; if interrupted, reinitiate at lower doses as above
  • Monitor: Serum Ca & phosphorus, iPTH

Pre-dialysis

Initial: 1 mcg PO qDay, may increase by 0.5 mcg/dose q2Weeks

Reduce or interrupt dose if iPTH concentration falls or Ca x P >55 mg²/dL² (consult package insert); reinitiate at least 0.5 mcg lower than last dose

Renal Impairment

Dose adjustment not necessary

Hepatic Impairment

Caution; guidelines not available

Other Indications & Uses

Secondary hyperparathyroidism associated with chronic kidney disease

Safety & efficacy not established

Next

Interactions

Interaction Checker

doxercalciferol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            Frequency Not Defined

            Edema

            Palpitation

            Chills

            Dizziness

            Headache

            Malaise

            Nausea

            Vomiting

            Hypercalcemia

            Hypercalciuria

            Anorexia

            Constipation

            Dyspepsia

            Arthralgia

            Edema

            Weight increase

            Sleep disorder

            Dyspnea Pruritus

            Postmarketing Reports

            Hypersensitivity reactions (patients on hemodialysis)

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity

            Hypercalcemia, hyperphosphatemia, hypervitaminosis D

            Cautions

            Monitor serum Ca & phosphorus frequently; reduce dose or stop the drug if Ca x P product >75 mg²/dL²

            Acute hypercalcemia may exacerbate tendencies for cardiac arrhythmias and seizures and may potentiate action of digitalis drugs; chronic hypercalcemia can lead to generalized vascular calcification and other soft-tissue calcification; in chronic kidney disease maintain Ca x P product at <55 mg²/dL²

            Use with caution in patients receiving digitalis; digitalis toxicity is potentiated by hypercalcemia

            Decrease dose if hypercalcemia or hyperphosphatemia occurs

            Serious hypersensitivity reactions, including fatal outcome, in patients on hemodialysis, reported post marketing; hypersensitivity reactions include anaphylaxis with symptoms of angioedema (involving face, lips, tongue and airways), hypotension, unresponsiveness, chest discomfort, shortness of breath, and cardiopulmonary arrest; reactions may occur separately or together

            Use oral calcium-based or other non-aluminum-containing phosphate binders and a low phosphate diet to control serum phosphorus levels in patients undergoing dialysis

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Doxercalciferol is metabolized to the active form of vitamin D, which in turn controls the reabsorption of calcium by the kidneys, controls the intestinal absorption of dietary calcium, and along with parathyroid hormone controls the mobilization of calcium from the skeleton.

            Absorption

            Onset: IV: 10-12 wk, PO: 3-4 months

            Peak Plasma Time: 8-12 hr

            Metabolism

            Metabolism: in liver to hepatic vitamin D 25-hydroxylases to 1,25-dihydroxyvitamin D2 (active)

            Metabolites: 1,25-dihydroxyvitamin D2 (active), responsible for most of metabolic effects of doxercalciferol and 1,24-dihydroxyvitamin D2 (minor metabolite)

            Elimination

            Half-Life: 32-37 hr (active metabolite 1,25-dihydroxyvitamin D2)

            Dialyzable: No (HD)

            Previous
            Next

            Administration

            Administration

            IV bolus

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.