Doxercalciferol

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.