Hectorol Injection Dosage

Generic name: doxercalciferol
Dosage form: injection, solution

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Adult Administration:

For intravenous use only. The optimal dose of Hectorol must be carefully determined for each patient.

The recommended initial dose of Hectorol is 4 mcg administered intravenously as a bolus dose three times weekly at the end of dialysis (approximately every other day). The initial dose should be adjusted, as needed, in order to lower blood iPTH into the range of 150 to 300 pg/mL. The dose may be increased at 8-week intervals by 1 to 2 mcg if iPTH is not lowered by 50% and fails to reach the target range. Dosages higher than 18 mcg weekly have not been studied. Drug administration should be suspended if iPTH falls below 100 pg/mL and restarted one week later at a dose that is at least 1 mcg lower than the last administered dose. During titration, iPTH, serum calcium, and serum phosphorus levels should be obtained weekly. If hypercalcemia, hyperphosphatemia, or a serum calcium times phosphorus product greater than 55 mg2/dL2 is noted, the dose of Hectorol should be decreased or suspended and/or the dose of phosphate binders should be appropriately adjusted. If suspended, the drug should be restarted at a dose that is 1 mcg lower.

Dosing must be individualized and based on iPTH levels with monitoring of serum calcium and serum phosphorus levels.  Table 5 presents a suggested approach in dose titration.

Table 5: Initial Dosing
iPTH Level Hectorol® Dose
>400 pg/mL 4 mcg three times per week at the end of dialysis, or approximately every other day
    Dose Titration
iPTH Level Hectorol® Dose
Decrease by <50% and above 300 pg/mL Increase by 1 to 2 mcg at eight-week intervals as necessary
Decrease by >50% and above 300 pg/mL  Maintain
150 - 300 pg/mL Maintain
<100 pg/mL    Suspend for one week, then resume at a dose that is at least 1 mcg lower

Multi-Dose Vial

After initial vial use, the contents of the multi-dose vial remain stable up to 3 days when stored at 2–8°C (36-46°F). Discard unused portion of multi-dose vial after 3 days. (see HOW SUPPLIED and STORAGE section).

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