Doxercalciferol: Uses, Dosage, Side Effects & Patient Guide

Summary of Key Points

Doxercalciferol is a prescription medication used to treat conditions related to low calcium levels and parathyroid disorders, such as secondary hyperparathyroidism, chronic kidney disease, and vitamin D deficiency. As a Vitamin D analog, it helps regulate calcium and phosphorus levels in the body. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions or concerns.

Names of Medication

US Brand Name: Hectorol

Generic Name: Doxercalciferol

The generic name, Doxercalciferol, refers to the active ingredient, while Hectorol is the brand name given by the manufacturer.

Pharmacologic Category

Vitamin D Analog

Doxercalciferol belongs to a class of medications known as Vitamin D analogs. These medications help regulate calcium and phosphorus levels, which are essential for maintaining bone health and ensuring the proper function of the parathyroid glands.

Doxercalciferol Dosing

Doxercalciferol is prescribed for various conditions, and the dosage may vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them. Our telemedicine providers are available to help manage your treatment.

1. Secondary Hyperparathyroidism (in adults with chronic kidney disease on dialysis): The initial dose is 10 mcg three times per week, administered intravenously at the end of dialysis. Dose adjustments may be made based on lab results.
2. Chronic Kidney Disease (not on dialysis): The initial dose is 1 mcg to 3.5 mcg taken orally once daily. Dose adjustments may be made based on lab results.
3. Osteodystrophy: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.
4. Hypoparathyroidism: The initial dose is 1 mcg to 3.5 mcg taken orally once daily. Dose adjustments may be made based on lab results.
5. Vitamin D Deficiency: The initial dose is 1 mcg to 3.5 mcg taken orally once daily. Dose adjustments may be made based on lab results.
6. Osteoporosis: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.
7. Rickets: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.
8. Renal Osteodystrophy: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.
9. Hyperphosphatemia: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.
10. Hypocalcemia: The dose varies depending on the severity of the condition. Consult your healthcare provider for personalized dosing recommendations.

Dosage Forms and Strengths

Doxercalciferol is available in the following forms and strengths:

1. Capsules: 0.5 mcg, 1 mcg, 2.5 mcg
2. Injection: 4 mcg/mL (2 mL vial)

Administration Instructions for Doxercalciferol

Doxercalciferol should be taken exactly as prescribed by your healthcare provider. If you are taking the capsule form, it is typically taken once daily, with or without food. If you are receiving the injection, it will be administered by a healthcare professional during dialysis. Do not crush or chew the capsules. If you miss a dose, take it as soon as you remember, but do not double up on doses. Always consult your healthcare provider if you have any questions about how to take your medication.

Adverse Reactions and Side Effects of Doxercalciferol

Like all medications, Doxercalciferol can cause side effects. Some are more common, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider immediately. Our telemedicine providers are available to assist with any concerns.

Common Side Effects

1. Headache: Mild to moderate headaches may occur as your body adjusts to the medication.
2. Nausea: Some patients may experience nausea, especially when starting the medication.
3. Edema (swelling): Swelling in the hands, feet, or ankles may occur.

Less Common but Serious Side Effects

1. Hypercalcemia (high calcium levels): Symptoms include confusion, fatigue, and increased thirst or urination. This is a serious condition that requires immediate medical attention.
2. Hyperphosphatemia (high phosphate levels): This can lead to complications in patients with kidney disease. Symptoms may include muscle cramps or joint pain.
3. Allergic reactions: Rarely, some patients may experience an allergic reaction, including rash, itching, or swelling. Seek emergency medical help if you experience difficulty breathing.

Contraindications for Doxercalciferol

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. It’s important to know if you have any of these conditions before starting Doxercalciferol.

1. Hypercalcemia (high calcium levels): Doxercalciferol increases calcium absorption, so if you already have high calcium levels, taking this medication can worsen the condition and lead to serious complications like kidney stones or heart problems.
2. Vitamin D toxicity: If you have too much vitamin D in your body, taking Doxercalciferol can further increase vitamin D levels and cause harmful effects, including high calcium levels and kidney damage.
3. Allergic reactions: If you are allergic to Doxercalciferol or any of its ingredients, taking the medication could cause severe allergic reactions, such as rash, swelling, or difficulty breathing.
4. Severe liver disease: Doxercalciferol is processed by the liver. If your liver is not functioning properly, the medication may not be metabolized correctly, increasing the risk of side effects.

Drug to Drug Interactions with Doxercalciferol

Some medications can interact with Doxercalciferol, potentially altering its effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements.

Cholestyramine (Prevalite, Questran): This medication may reduce the absorption of Doxercalciferol, making it less effective.

Phenytoin (Dilantin) and Phenobarbital: These anti-seizure medications can accelerate the breakdown of Doxercalciferol, decreasing its effectiveness.

Thiazide diuretics (Hydrochlorothiazide, Microzide): These medications can increase calcium levels in the blood, which may lead to hypercalcemia when taken with Doxercalciferol.

Magnesium-containing antacids: Using these antacids alongside Doxercalciferol can result in elevated magnesium levels, particularly in individuals with kidney disease.

Doxercalciferol in Pregnancy

Is it safe to take Doxercalciferol during pregnancy?

The safety of Doxercalciferol during pregnancy has not been fully established. It should only be used if the potential benefits outweigh the risks to the developing fetus. If you are pregnant or planning to become pregnant, consult your healthcare provider to determine whether Doxercalciferol is appropriate for you. Our telemedicine providers are available to help you make an informed decision based on your unique health needs.

Doxercalciferol while Breastfeeding

Is it safe to take Doxercalciferol while breastfeeding?

It is unclear whether Doxercalciferol passes into breast milk. Since vitamin D can influence calcium levels in both the mother and baby, it’s essential to consult your healthcare provider before using Doxercalciferol while breastfeeding. You can also speak with one of our telemedicine providers to explore the safest options for you and your baby.

Estimated Cost of Doxercalciferol Medication

The cost of a 30-day supply of Doxercalciferol without insurance can vary. With a GoodRX coupon, prices typically range from $50 to $100, depending on the pharmacy and dosage. For the most accurate pricing, check with your local pharmacy.

Possible Alternatives to Doxercalciferol

If Doxercalciferol is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these alternatives with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to guide you through these options.

1. Secondary hyperparathyroidism: Alternatives include other vitamin D analogs such as Calcitriol (Rocaltrol) or Paricalcitol (Zemplar). Dietary changes, like reducing phosphorus intake, may also help manage symptoms.
2. Chronic kidney disease: Managing phosphorus levels through diet or phosphate binders, along with medications like Cinacalcet (Sensipar), may be recommended. Regular monitoring of calcium and phosphorus levels is essential.
3. Osteodystrophy: Treatment may involve calcium and vitamin D supplements, along with medications to regulate bone turnover, such as bisphosphonates.
4. Hypoparathyroidism: Calcium supplements and active forms of vitamin D, such as Calcitriol, are commonly used. In some cases, parathyroid hormone replacement therapy may be considered.
5. Vitamin D deficiency: Over-the-counter vitamin D supplements or prescription-strength vitamin D may be used. Sunlight exposure and dietary changes can also help increase vitamin D levels.
6. Osteoporosis: Bisphosphonates, hormone therapy, or medications like Denosumab (Prolia) may be prescribed to strengthen bones. Weight-bearing exercises and calcium-rich diets are also beneficial.
7. Rickets: Vitamin D and calcium supplements are the primary treatment. Adequate sunlight exposure and a balanced diet can also help prevent rickets.
8. Renal osteodystrophy: Phosphate binders, vitamin D analogs, and dietary changes to control phosphorus intake are commonly used treatments.
9. Hyperphosphatemia: Phosphate binders, such as Sevelamer (Renvela) or Lanthanum (Fosrenol), are often prescribed. Dietary changes to reduce phosphorus intake are also recommended.
10. Hypocalcemia: Calcium supplements and active forms of vitamin D, such as Calcitriol, are typically used to manage low calcium levels.

Recent Updates on Doxercalciferol Research

Recent studies have focused on Doxercalciferol’s role in managing secondary hyperparathyroidism in patients with chronic kidney disease. Research suggests that Doxercalciferol may effectively reduce parathyroid hormone (PTH) levels without causing as much hypercalcemia as other vitamin D analogs. Ongoing studies are also exploring its long-term effects on bone health and cardiovascular outcomes in patients with chronic kidney disease. As more data becomes available, it will help refine treatment guidelines and improve patient outcomes.

For the latest updates on Doxercalciferol and how it may impact your treatment plan, consider scheduling a telemedicine appointment with one of our providers. We can help you stay informed and make the best decisions for your health.

James Kingsley

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