PO (Adults): 30 mcg once daily at bedtime; if desired intact PTH level remains elevated after 3 mo, ↑ to 60 mcg once daily at bedtime. Maintenance dose should target total 25-hydroxyvitamin D levels of 30–100 ng/mL, intact PTH levels within desired therapeutic range, serum calcium <9.8 mg/dL, and serum phosphorus ≤5.5 mg/dL.
Extended-release capsules: 30 mcg
Monitor for signs and symptoms of hypercalcemia (feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, weight loss) during therapy. May increase risk of cardiac arrhythmias and seizures. May require frequent monitoring and change in dose.
Monitor serum and signs and symptoms of digitalis toxicity (abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, other arrhythmias) during therapy in patients taking concomitant digoxin. Hypercalcemia may increase risk of digitalis toxicity in patients taking digoxin.
Monitor for signs and symptoms of adynamic bone disease (fractures) during therapy. May develop if intact PTH levels are abnormally low due to suppression by calcifediol.
Lab Test Considerations:
Ensure serum calcium is <9.8 mg/dL before starting therapy.
Monitor serum calcium, phosphorus, total 25-hydroxyvitamin D and intact PTH levels at least every 3 mo after starting therapy or dose adjustment, and then at least every 6 to 12 mo.
PO Administer at bedtime; swallow capsules whole, do not open, crush, or chew.
Instruct patient to take calcifediol as directed. If a dose is missed, omit and take next dose at the next regularly scheduled time; do not double doses.
Advise patient to notify health care professional if signs and symptoms of hypercalcemia occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
Emphasize importance of routine lab tests.
Rep: Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Monitor infants exposed to calcifediol through breast milk for signs and symptoms of hypercalcemia, including seizures, vomiting, constipation and weight loss. Consider monitoring of serum calcium in the infant.
Serum total hydroxyvitamin D levels between 30 and 100 ng/mL, intact PTH levels within therapeutic range, serum calcium (corrected for low albumin) within normal range and serum phosphorus <5.5 mg/dL.
calcifediol is a sample topic from the Davis's Drug Guide.
Davis’s Drug Guide for Nurses App + Web from F.A. Davis and Unbound Medicine covers 5000+ trade name and generic drugs. Includes App for iPhone, iPad, and Android smartphone + tablet. Handbook covers dosage, side effects, interactions, uses. Davis Drug Guide PDF. Complete Product Information.