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Secondary hyperparathyroidism or hypocalcemia
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Generic Name and Formulations:

Doxercalciferol 2mcg/mL; soln for IV inj.

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Indications for HECTOROL INJ:

Secondary hyperparathyroidism in patients with chronic kidney disease (CKD) on dialysis.


Dialysis: 4mcg three times weekly after dialysis; adjust dose to maintain intact parathyroid hormone (iPTH) between 150–300pg/mL. If iPTH is not lowered by 50% and fails to reach target range, may increase by 1–2mcg at 8-week intervals. Max 18mcg/week. If iPTH <100pg/mL, suspend for 1 week, then resume at a dose that is at least 1mcg lower.


Not established.


Hypercalcemia. Vit.D toxicity.


Maintain appropriate calcium, phosphate, fluid intake. Keep serum calcium times phosphate product (Ca × P) <55 in CKD patients. Monitor iPTH, serum calcium, phosphorus (dialysis: at baseline and weekly thereafter; predialysis: every 2 weeks for 3 months during titration, then monthly for 3 months and every 3 months thereafter). Adjust phosphate binder dose to maintain PTH suppression and serum calcium and phosphate levels. Hepatic impairment. Inj: monitor for hypersensitivity at initiation; discontinue and treat if occurs. Pregnancy (Cat.B). Nursing mothers: not recommended.

See Also:


Pharmacological Class:

Vit. D analog.


Additive effects and hypercalcemia with concomitant other forms of Vit.D. Hypermagnesemia with magnesium-containing antacids. May be affected by CYP450 inhibitors (eg, ketoconazole, erythromycin) or hepatic enzyme inducers (eg, glutethimide, phenobarbital); dose adjustments may be needed.

Adverse Reactions:

Edema, headache, malaise, nausea, vomiting, arthralgia, weight increase, dizziness, sleep disorder, dyspnea; Vit.D toxicity (eg, hypercalcemia, hypercalciuria, hyperphosphatemia, adynamic bone diseases, arrhythmias, seizures); see full labeling.

How Supplied:

Caps—50; Single-use vial (1mL, 2mL)—1; Multi-dose vial (2mL)—1