Doxercalciferol
Doxercalciferol is a synthetic vitamin D2 analog used to treat secondary hyperparathyroidism, particularly in patients with chronic kidney disease. It requires metabolic activation in the liver to form the active metabolite 1α,25-(OH)2D2, which then binds to vitamin D receptors to regulate calcium and phosphate metabolism.
A vitamin D2 analog that treats secondary hyperparathyroidism by activating vitamin D-responsive pathways after metabolic conversion.
Key facts at a glance
- ATC
- H05BX03
- RxNorm
- 11516
- Generic
- Doxercalciferol
- Class
- atc-h05
- Brands
- Hectorol
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- injection, capsule, solution
- 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
9 groupspregnancy
first trimesteravoid if possible
Use only if benefits outweigh risks. Doxercalciferol is a vitamin D analog that may cross the placental barrier.
regular fetal monitoring, monitor maternal calcium levels
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
Use only if benefits outweigh risks. Close monitoring of maternal and fetal calcium levels required.
intensive fetal monitoring, ultrasound for fetal growth
Use with caution and monitor for adverse effects.
lactation
breastfeedingavoid
Breastfeeding not recommended during treatment due to lack of safety data
monitor infant for signs of hypercalcemia if breastfeeding continues
pediatric_age
children adolescentsnot established
Safety and effectiveness not established in pediatric patients. Use only if clearly needed.
close monitoring of calcium, phosphorus, and PTH levels
geriatric
elderlyno specific adjustment, start low
Use with caution. Start at lower end of dosing range. Monitor renal function and calcium levels.
regular monitoring of calcium, phosphorus, renal function
Use with caution and monitor for adverse effects.
renal_impairment
ESRD dialysisinitiate at lower dose
Doxercalciferol is specifically indicated for secondary hyperparathyroidism in CKD patients on dialysis. Monitor calcium and phosphorus closely.
frequent monitoring of serum calcium, phosphorus, and PTH levels
renal_impairment
mild moderate CKDadjust dose based on PTH levels
Use with caution. Dose adjustment may be needed based on renal function and PTH levels.
regular monitoring of renal function, calcium, phosphorus, PTH
Use with caution and monitor for adverse effects.
hepatic_impairment
mild moderatemay require dose reduction
Use with caution. Hepatic impairment may affect activation of doxercalciferol. Monitor calcium levels closely.
monitor calcium, phosphorus, PTH, and liver function
Use with caution and monitor for adverse effects.
alcohol_users
chronic alcohol useuse with caution
Chronic alcohol use may increase risk of liver damage and vitamin D deficiency. Monitor liver function and calcium levels.
regular monitoring of liver function, calcium, phosphorus
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
Hectorol (doxercalciferol) approved for treatment of secondary hyperparathyroidism
Drug class
Synthetic vitamin D2 analog (1α-hydroxyvitamin D2)
Primary indication
Treatment of hyperparathyroidism in chronic kidney disease patients on hemodialysis
Mechanism of action
Increases active vitamin D levels to suppress PTH secretion
Treatment of secondary hyperparathyroidism in patients with chronic kidney disease, particularly those on dialysis. May also be used for refractory Rickets and familial hypophosphatemic Rickets (X-linked hypophosphatemic Rickets).
Doxercalciferol is a prodrug that requires hepatic activation to form 1α,25-(OH)2D2 (calcitriol). This active metabolite binds to the vitamin D receptor (VDR), selectively activating vitamin D-responsive gene pathways that regulate calcium absorption, phosphate metabolism, and parathyroid hormone secretion.
Requires regular monitoring of serum calcium, phosphorus, and parathyroid hormone (PTH) levels due to risk of hypercalcemia. Should be used with caution in patients with normal kidney function as activation may be excessive. Avoid use with other vitamin D compounds to prevent toxicity. Contraindicated in patients with hypercalcemia or evidence of vitamin D toxicity.
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