National Stroke Foundation

Hectorol (Doxercalciferol) Injection

The following drug information is obtained from various newswires, published medical journal articles, and medical conference presentations.

Approval Status:

Approved April 2000

Specific Treatments:

For the reduction of iPTH levels in mgmt. of secondary hyperparathyroidism in patients undergoing chronic renal dialysis

Therapeutic Areas

General Information

Hectorol is indicated for the prevention of excessive parathyroid hormone production in patients with chronic renal failure who are undergoing chronic hemodialysis.

(Hectorol is also being tested as a treatment for osteoporosis and prostate cancer.)

Clinical Results

Two clinical studies investigated the effects of Hectorol Injection. The 70 patients involved in the studies all had chronic renal disease and were on hemodialysis. All of these patients had been treated with Hectorol Capsules in previous clinical studies. The patients were given the investigational drug in an open-label manner over a 12-week period. The drug was administered following each of 3 dialysis sessions a week at a rate of 4.0 mcg per injection. However, the dosage was adjusted in order to reach the targeted iPTH levels of 150 to 300 pg/mL.

The Hectorol Injection resulted in statistically significant decreases from baseline in mean iPTH levels. 92% of the participants experienced at least a 30% decrease.

Approximately 74% of the patients treated achieved iPTH levels less than or equal to 300 pg/mL. 51% of the patients had iPTH levels less than 150 pg/mL at least on point in the study. However, the dosages were decreased when this occurred.

In the first study, mean weekly doses ranged from 8.9 mcg to 12.5 mcg. In the second, the mean dosage range was from 9.1 mcg to 11.6 mcg.

Side Effects

Hectorol is contraindicated in patients with a history of hypercalcemia or evidence of vitamin D toxicity.

Hectorol should not be administered while the patient is taking other forms of vitamin D, since vitamin D overdose is dangerous.

Over 10% of patients taking Hectorol experienced one or more of the following adverse reactions:

  • Headache
  • Malaise
  • Dizziness
  • Edema
  • Nausea/vomiting
  • Dyspnea (abnormal breathing [pattern, rate, etc.])

Mechanism of Action

Calcitriol regulates blood calcium at levels required for essential body functions. Specifically, the biologically active vitamin D metabolites control the intestinal absorption of dietary calcium, the tubular reabsorption of calcium by the kidney and, in conjunction with parathyroid hormone (PTH), the mobilization of calcium from the skeleton. They act directly on bone cells (osteoblasts) to stimulate skeletal growth, and on the parathyroid glands to suppress PTH synthesis and secretion. These functions are mediated by the interaction of these biologically active metabolites with specific receptor proteins in the various target tissues. In uremic patients, deficient production of biologically active vitamin D metabolites (due to lack of or insufficient 25-hydroxyvitamin D-1-alpha-hydroxylase activity) leads to secondary hyperparathyroidism, which contributes to the development of metabolic bone disease in patients with renal failure. (From FDA Label)

Additional Information

Visit the Bone Care International web site to learn more about Hectorol and about other products, research, and services provided by the company that developed this drug.

Health care professionals and patients:
Visit the National Kidney Foundation web site for more information about current treatments, research, and news stories in the field of kidney disease treatment.