More from Doxerol
Other strengths and forms by Advanced Chemical Industries PLC.
Indications & Uses
Doxercalciferol injection is used to treat secondary hyperparathyroidism in adults with CKD who are on dialysis.
Pharmacology
Doxercalciferol is a synthetic analog of vitamin D2. The body has to activate it first, and this gives the active metabolite 1α, 25-dihydroxyvitamin D2 (1α,25-(OH)2D2). This metabolite binds to the vitamin D receptor (VDR), and that selectively switches on the pathways that respond to vitamin D. Both vitamin D and doxercalciferol have been shown to lower PTH levels, because they inhibit the synthesis and the secretion of PTH.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
The route of administration for Doxercalciferol injection is intravenous. Before you start treatment, make sure serum calcium is not above the upper limit of normal.
Give Doxercalciferol injection as a bolus dose at the end of dialysis. Look at the solution before giving it. It should be clear and colorless. Don't use it if it isn't clear or if particles are present.
Start at a dose of 4 meg, given by bolus intravenous administration three times weekly at the end of dialysis (no more frequently than every other day). Aim the maintenance dose of Doxercalciferol at intact parathyroid hormone (PTH) levels within the desired therapeutic range, with serum calcium within normal limits. Check serum calcium, phosphorus and intact PTH weekly after starting therapy or after any dose adjustment. Adjust the dose of Doxercalciferol injection based on intact PTH. The dose may be increased at 8-week intervals by 1 meg to 2 meg if intact PTH is not lowered by 50% and fails to reach the target range. The maximum dose is 18 meg weekly. Before raising the dose, make sure serum calcium is within normal limits. Suspend or decrease the dose if intact PTH is persistently and abnormally low, to reduce the risk of adynamic bone disease, or if serum calcium is consistently above the normal range, to reduce the risk of hypercalcemia. If the drug is suspended, restart it one week later at a dose that is at least 1 meg lower.
The safety and effectiveness of doxercalciferol in children and adolescents (pediatric patients) have not been established.
Side Effects
The most common side effects of Doxercalciferol are infections (including bacterial and viral infections), constipation, rhinitis, anemia and cough. Some people also get dyspnea, paresthesia, asthenia, insomnia, hypertonia and angina pectoris.
Cautions & Contraindications
Warnings & Precautions
Hypercalcemia can happen during treatment with Doxercalciferol, and it can lead to cardiac arrhythmias and seizures. Severe hypercalcemia may need emergency attention. Serum calcium should be checked before treatment starts and again during treatment, and the dose adjusted accordingly. Anaphylaxis has been reported in hemodialysis patients after they were given Doxercalciferol. The symptoms were angioedema, hypotension, unresponsiveness, chest discomfort, shortness of breath and cardiopulmonary arrest. Patients should be watched for hypersensitivity reactions when treatment begins. If a hypersensitivity reaction occurs, stop the medicine and treat if indicated. Adynamic bone disease may develop and raise the risk of fractures if intact PTH levels are suppressed to abnormally low levels. Intact PTH levels should be monitored to avoid oversuppression, and the dose adjusted if needed. In patients with hepatic impairment, intact PTH, calcium and phosphorus levels should be checked more often.
Contraindications
Doxercalciferol must not be given to patients who are known to be hypersensitive to it or to any other component of the product. It is also contraindicated in hypercalcemia and in vitamin D toxicity.
Pregnancy & Breastfeeding
There isn't much data on doxercalciferol in pregnant women, and what exists is not enough to show whether the medicine carries a risk of major birth defects, miscarriage or other harmful outcomes for the mother or the baby. If a mother is breastfeeding, the benefits of breastfeeding for the baby's development and health should be weighed against her own clinical need for doxercalciferol. Any possible harm to the breastfed infant, whether from doxercalciferol or from the mother's underlying condition, should also be considered.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Taking too much Doxercalciferol can cause hypercalcemia, hypercalciuria and hyperphosphatemia. If someone has had an acute overdose, treatment is supportive, and Doxercalciferol must be stopped. Serum calcium should be checked until it returns to normal. Dialysis is not expected to remove Doxercalciferol from the blood.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Doxercalciferol out of the reach of children. Store it in a cool, dry place below 25°C, away from light. Once you have opened it and used it for the first time, you can keep any unused portion in a refrigerator at 2°C to 8°C for 3 days if needed.
Drug Interactions
Common questions about Doxerol 4 mcg/2 ml
What is Doxerol 4 mcg/2 ml IV Injection?
Doxerol 4 mcg/2 ml IV Injection is a medicine that contains Doxercalciferol. It is made by Advanced Chemical Industries PLC.
What is Doxerol used for?
Doxercalciferol injection is used to treat secondary hyperparathyroidism in adults with CKD who are on dialysis.
What are the side effects of Doxerol?
The most common side effects of Doxercalciferol are infections (including bacterial and viral infections), constipation, rhinitis, anemia and cough. Some people also get dyspnea, paresthesia, asthenia, insomnia, hypertonia and angina pectoris.
Can I take Doxerol during pregnancy or while breastfeeding?
There isn't much data on doxercalciferol in pregnant women, and what exists is not enough to show whether the medicine carries a risk of major birth defects, miscarriage or other harmful outcomes for the mother or the baby. If a mother is breastfeeding, the benefits of breastfeeding for the baby's development and health should be weighed against her own clinical need for doxercalciferol. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Doxerol?
Taking too much Doxercalciferol can cause hypercalcemia, hypercalciuria and hyperphosphatemia. If someone has had an acute overdose, treatment is supportive, and Doxercalciferol must be stopped. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Doxerol?
Keep Doxercalciferol out of the reach of children. Store it in a cool, dry place below 25°C, away from light.
Can I take other medicines with Doxerol?
Some medicines can interact with Doxercalciferol, for example: Magnesium, Phenobarbital. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Doxerol?
Doxerol is a prescription (Rx) medicine. Take it as your doctor advises.