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Doxerol

Doxerol
- IV Injection
Generic name: Doxercalciferol
2 mcg/ml
Manufactured by: ACI Limited

2 mcg vial: ৳ 480.00

Alternative Brand

Doxercalciferol injection is indicated for the treatment of secondary hyperparathyroidism in adult patients with CKD on dialysis.

Doxercalciferol is a synthetic vitamin D2 analog. It requires metabolic activation to form the active 1α, 25-dihydroxyvitamin D2 (1α,25-(OH)2D2) metabolite, which binds to the vitamin D receptor (VDR) to result in the selective activation of vitamin D responsive pathways. Vitamin D and Doxercalciferol have been shown to reduce PTH levels by inhibiting PTH synthesis and secretion.

Drug interaction with medication: Concomitant administration of high doses of calcium-containing preparations or other vitamin D compounds may increase the risk of hypercalcemia. Thiazide diuretics are known to induce hypercalcemia by reducing excretion of calcium in the urine. Monitor serum calcium concentrations more frequently and adjust doxercalciferol dose as needed. Doxercalciferol can cause hypercalcemia which can potentiate the risk of digitalis toxicity. Monitor patients for signs and symptoms and increase frequency of serum calcium monitoring when initiating or adjusting the dose of doxercalciferol in patients receiving digitalis compounds. Cytochrome P450 inhibitors may inhibit the 25-hydroxylation of doxercalciferol and thus reduce the formation of active doxercalciferol moiety. If a patient initiates or discontinues therapy with a cytochrome P450 inhibitor, dose adjustment of doxercalciferol may be necessary. Monitor intact PTH and serum calcium concentrations closely. Enzyme inducers (e.g., glutethimide and phenobarbital) may affect the 25-hydroxylation of doxercalciferol. If a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of doxercalciferol may be necessary. Concomitant administration of doxercalciferol and high doses of magnesium-containing products may increase the risk of hypermagnesemia. Avoid use of magnesium-containing products and doxercalciferol in patients on chronic renal dialysis.

Most common side effects are infection/bacterial infection/viral infection, constipation, rhinitis, anemia, cough, dyspnea, paresthesia, asthenia, insomnia, hypertonia and angina pectoris.

The limited available data with doxercalciferol in pregnant women are insufficient to identify a drug-associated risk for major birth defects, miscarriage or adverse maternal or fetal outcomes. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for doxercalciferol and any potential adverse effects on the breastfed infant from doxercalciferol or from the underlying maternal condition.

Hypercalcemia can occur during treatment with doxercalciferol and can lead to cardiac arrhythmias and seizures. Severe hypercalcemia may require emergency attention. Monitor serum calcium prior to initiation and during treatment and adjust dose accordingly. Anaphylaxis, with symptoms of angioedema, hypotension, unresponsiveness, chest discomfort, shortness of breath and cardiopulmonary arrest, has been reported in hemodialysis patients after administration of doxercalciferol. Monitor patients upon treatment initiation for hypersensitivity reactions. Should a hypersensitivity reaction occur, discontinue and treat if indicated. Adynamic bone disease may develop and increase risk of fractures if intact PTH levels are suppressed to abnormally low levels. Monitor intact PTH levels to avoid oversuppression and adjust dose if needed. More frequent monitoring of intact PTH, calcium and phosphorus levels should be done in patients with hepatic impairment.

Overdosage of doxercalciferol may lead to hypercalcemia, hypercalciuria, and hyperphosphatemia. The treatment of acute overdosage should consist of supportive measures and discontinuation of doxercalciferol administration. Serum calcium levels should be measured until normal. It is expected that doxercalciferol is not removed from the blood by dialysis.

Keep away from the reach of children. Store in a cool (below 25°C) & dry place protected from light. After first use, unused portion can be stored for 3 days in a refrigerator at 2°C to 8°C if required.

Alternative Brand Names

IV Injection
Doxerol
Doxercalciferol
4 mcg/2 ml
ACI Limited

4 mcg vial: ৳ 700.00

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All Medicine