calcitriol

Adult Dosing .

Dosage forms:  CAP: 0.25 mcg, 0.5 mcg; SOL: 1 mcg per mL; INJ: various

secondary hyperparathyroidism, pre-dialysis pts

[0.25-0.5 mcg PO qd]

Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q4-8wk; Info: for pts w/ mod-severe CRF; see pkg insert for dose adjustments based on Ca and PTH levels; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

hypocalcemia, dialysis pts

[PO route]

Dose: 0.25-1 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q4-8wk; Alt: 0.25 mcg PO qod if Ca normal or near-normal; Info: see pkg insert for dose adjustments based on Ca levels; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[IV route]

Dose: 0.5-4 mcg IV 3x/wk; Start: 1-2 mcg IV 3x/wk, incr. 0.5-1 mcg/dose q2-4wk based on response; Info: see pkg insert for dose adjustments based on PTH levels; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

hypocalcemia, hypoparathyroidism-assoc.

[0.5-2 mcg PO qd]

Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q2-4wk; Info: for post-surgery, idiopathic, or pseudo-hypoparathyroidism

rickets, vitamin D-dependent (off-label)

[1 mcg PO qd]

hypophosphatemia, familial (off-label)

[2 mcg PO qd]

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  CAP: 0.25 mcg, 0.5 mcg; SOL: 1 mcg per mL; INJ: various

secondary hyperparathyroidism, pre-dialysis pts

[<3 yo]

Dose: 0.01-0.015 mcg/kg/dose PO qd; Start: 0.01 mcg/kg/dose PO qd, incr. 0.005-0.01 mcg/kg/day q4-8wk; Info: for pts w/ mod-severe CRF; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[3 yo and older]

Dose: 0.25-0.5 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q4-8wk; Info: for pts w/ mod-severe CRF; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

hypocalcemia, hypoparathyroidism-assoc.

[<1 yo]

Dose: 0.04-0.08 mcg/kg/dose PO qd; Info: for post-surgery or idiopathic hypoparathyroidism; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[1-5 yo]

Dose: 0.25-0.75 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q2-4wk; Info: for post-surgery or idiopathic hypoparathyroidism; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[6 yo and older]

Dose: 0.5-2 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q2-4wk; Info: for post-surgery, idiopathic, or pseudo-hypoparathyroidism; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

hypocalcemia, dialysis pts (off-label)

[PO route, 1-5 yo]

Dose: 0.25-2 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q4-8wk; Alt: 0.25 mcg PO qod if Ca normal or near-normal; Info: D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[PO route, 6 yo and older]

Dose: 0.25-1 mcg PO qd; Start: 0.25 mcg PO qd, incr. 0.25 mcg/day q4-8wk; Alt: 0.25 mcg PO qod if Ca normal or near-normal; Info: D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

[IV route, 13 yo and older]

Dose: 1-1.4 mcg/wk IV divided 3x/wk; Start: 0.5-1.5 mcg IV 3x/wk; Info: adjust by 0.25 mcg increments based on iPTH, Ca and Ca x PO4; see pkg insert for dose adjustments based on PTH levels; D/C if hypercalcemia or Ca x PO4 product >70, may restart at lower dose once parameters appropriate

rickets, vitamin D-dependent (off-label)

[1 mcg PO qd]

hypophosphatemia, familial (off-label)

[0.03-0.06 mcg/kg/dose PO qd]

Start: 0.015-0.02 mcg/kg/day; Max: 2 mcg/day

hypocalcemia, neonates (off-label)

[PO route]

Dose: 0.25-1 mcg PO qd

[IV route]

Dose: 0.25 mcg IV qd; Info: switch to PO ASAP

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[not defined]