Calcifediol
Calcifediol is a vitamin D3 prohormone used to treat vitamin D deficiency and related conditions, particularly in patients with chronic kidney disease, as it is converted to the active form calcitriol.
Calcifediol is a vitamin D3 precursor that treats deficiency by converting to active vitamin D (calcitriol) in the kidneys.
Key facts at a glance
- ATC
- A11CC06
- RxNorm
- 1889
- Generic
- Calcifediol
- Class
- atc-a11
- Brands
- Rayaldee
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
all trimestersavoid unless benefits outweigh risks
use only if clearly needed and benefits justify potential risks to fetus
regular prenatal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno specific adjustment
use with caution, monitor infant serum calcium if prolonged use
monitor infant for hypercalcemia symptoms
Use with caution and monitor for adverse effects.
geriatric
elderlyno adjustment needed
standard dosing with regular monitoring of calcium and PTH
periodic serum calcium, phosphorus, and PTH monitoring
pediatric_age
children under 18not established
not recommended due to lack of established safety and efficacy data
not applicable
renal_impairment
chronic kidney diseasemay require dose adjustment based on severity
this is the indicated population for secondary hyperparathyroidism in CKD
regular monitoring of serum calcium, phosphorus, and PTH
hepatic_impairment
mild to moderateno specific adjustment recommended
use with caution, monitor liver function
periodic liver function tests
Use with caution and monitor for adverse effects.
alcohol_users
chronic alcohol useconsider supplementation
alcohol may impair vitamin D metabolism, may require higher doses
monitor 25-hydroxyvitamin D levels
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
Rayaldee received FDA approval in November 2016
Drug class
Calcifediol is a synthetic analog of 25-hydroxyvitamin D3
Common uses
Indicated for the treatment of secondary hyperparathyroidism in adults with chronic kidney disease stage 3 or 4
Mechanism of action
Calcifediol is converted to active 1,25-dihydroxyvitamin D which increases intestinal absorption of calcium and phosphorus
Treatment of vitamin D deficiency, secondary hyperparathyroidism associated with chronic kidney disease, and management of renal osteodystrophy (bone disease related to kidney failure). May also be used for hypoparathyroidism and certain types of rickets.
Calcifediol (25-hydroxyvitamin D3) is a naturally occurring intermediate in vitamin D metabolism. It is converted by the enzyme CYP27B1 (1-alpha hydroxylase) in the kidney to calcitriol (1,25-dihydroxyvitamin D3), the hormonally active form of vitamin D that regulates calcium absorption in the intestines, bone mineralization, and parathyroid hormone secretion.
Monitor serum calcium and phosphorus levels during treatment to avoid hypercalcemia. Use with caution in patients with kidney stones, sarcoidosis, or hyperparathyroidism. Drug interactions may occur with thiazide diuretics, lithium, and other vitamin D supplements. Not suitable for patients with severe liver disease where conversion to 25-hydroxyvitamin D is impaired.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy