Doxercalciferol

Doxercalciferol Brand Name– Hectorol

What is Doxercalciferol

Doxercalciferol (1alpha-hydroxyvitamin D₂, 1alpha-hydroxyergocalciferol, or 1alpha-OH-D₂) is a synthetic vitamin D analog indicated for the treatment of secondary hyperparathyroidism in adult patients with Stage 3 or 4 chronic kidney disease (CKD) or patients with CKD on dialysis.

Vitamin D occurs in 2 primary forms: cholecalciferol (vitamin D₃), which is synthesized in the skin after exposure to ultraviolet light, and ergocalciferol (vitamin D₂), which is produced from plant sterols and is the primary dietary source of vitamin D.

Vitamin D₂ and D₃ must undergo activation in the liver and kidney; however, doxercalciferol is activated by the liver alone.

Unlike calcitriol, doxercalciferol does not stimulate the absorption of dietary calcium from the intestine.

While doxercalciferol does cause an increased incidence of hypercalcemia and hyperphosphatemia as compared to placebo, the majority of patients do not show signs of toxicity.

In randomized control trials of doxercalciferol, parathyroid hormone concentrations (PTH) were reduced to the target range or were decreased by at least 30% from baseline in approximately 90% of treated patients.

Indications

• hyperparathyroidism
• renal osteodystrophy

Side Effects

1. anaphylactoid reactions
2. anemia
3. angina
4. angioedema
5. anorexia
6. arthralgia
7. asthenia
8. bone fractures
9. bone pain
10. bradycardia
11. cardiac arrest
12. chest pain (unspecified)
13. coma
14. confusion
15. constipation
16. cough
17. dehydration
18. depression
19. dizziness
20. drowsiness
21. dyspepsia
22. dyspnea
23. edema
24. elevated hepatic enzymes
25. fatigue
26. headache
27. hypercalcemia
28. hypercalciuria
29. hypercholesterolemia
30. hyperphosphatemia
31. hypertension
32. hyperthermia
33. hypertonia
34. hypervitaminosis D
35. hypotension
36. infection
37. insomnia
38. leukopenia
39. libido decrease
40. malaise
41. metallic taste
42. nausea
43. nocturia
44. pancreatitis
45. paresthesias
46. photophobia
47. polydipsia
48. polyuria
49. pruritus
50. psychosis
51. respiratory arrest
52. rhinitis
53. rhinorrhea
54. sinusitis
55. vomiting
56. weakness
57. weight gain
58. weight loss
59. xerostomia

Monitoring Parameters

• serum calcium
• serum intact parathyroid hormone concentrations (iPTH)
• serum phosphate

Contraindications

• breast-feeding
• hepatic disease
• hypercalcemia
• hyperphosphatemia
• hypervitaminosis D
• pregnancy

Interactions

• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Diphenhydramine
• Acetaminophen; Propoxyphene
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiloride; Hydrochlorothiazide, HCTZ
• Amiodarone
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amobarbital
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Aprepitant, Fosaprepitant
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Omeprazole
• Atenolol; Chlorthalidone
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azilsartan; Chlorthalidone
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bosentan
• Bupropion
• Bupropion; Naltrexone
• Burosumab
• Butabarbital
• Calcifediol
• Calcitonin
• Calcitriol
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Chlorothiazide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cholestyramine
• Chromium
• Cimetidine
• Cinacalcet
• Clarithromycin
• Clopidogrel
• Colestipol
• Cyclosporine
• Danazol
• Delavirdine
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Quinidine
• Digoxin
• Dihydrotachysterol
• Diltiazem
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Disulfiram
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Duloxetine
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Enalapril; Hydrochlorothiazide, HCTZ
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erythromycin
• Erythromycin; Sulfisoxazole
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Fluconazole
• Fosinopril; Hydrochlorothiazide, HCTZ
• Gemfibrozil
• grapefruit juice
• Haloperidol
• Hetastarch; Dextrose; Electrolytes
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Ibritumomab Tiuxetan
• Imatinib
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ketoconazole
• Leflunomide
• Magnesium
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salts
• Mephobarbital
• Methohexital
• Methyclothiazide
• Metolazone
• Metronidazole
• Mifepristone
• Mineral Oil
• Modafinil
• Nevirapine
• Omeprazole
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Orlistat
• Paricalcitol
• Pentobarbital
• Phenicol Derivatives
• Phenobarbital
• Phosphorated Carbohydrate Solution
• Phosphorus
• Polycarbophil
• Potassium Phosphate
• Potassium Phosphate; Sodium Phosphate
• Primidone
• Propafenone
• Propoxyphene
• Protease inhibitors
• Quinidine
• Quinine
• Ranolazine
• Rifabutin
• Rifampin
• Secobarbital
• Segesterone Acetate; Ethinyl Estradiol
• Selective serotonin reuptake inhibitors
• St. John’s Wort, Hypericum perforatum
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Tacrine
• Terbinafine
• Thiazide diuretics
• Thiopental
• Thioridazine
• Ticlopidine
• Trandolapril; Verapamil
• Verapamil
• Voriconazole
• Zafirlukast
• Zileuton