Seen primarily as manifestations of toxicity (hypercalcemia)
CV: arrhythmias, hypertension.
Derm: pruritus.
EENT: conjunctivitis, photophobia, rhinorrhea.
F and E: hypercalcemia.
GI: abdominal pain, anorexia, constipation, dry mouth, ↑ liver enzymes, metallic taste, nausea, PANCREATITIS, polydipsia, vomiting.
GU: albuminuria, azotemia, ↓ libido, nocturia, polyuria.
Local: pain at injection site.
Metab: hyperthermia, weight loss.
MS: bone pain, metastatic calcification, muscle pain.
Neuro: headache, somnolence, weakness.
Misc: hypersensitivity reactions.
Hypocalcemia During Dialysis
- PO (Adults): 0.25 mcg/day or every other day; if needed, may ↑ by 0.25 mcg/day at 4–8 wk intervals (typical dosage = 0.5–1 mcg/day).
- PO (Children <10 kg): 0.05 mcg every other day; 10–20 kg: 0.1–0.15 mcg daily; >20 kg 0.25 mcg daily.
Hypoparathyroidism
- PO (Adults and Children
6 yr): 0.25 mcg/day initially; if needed, may ↑ dose by 0.25 mcg/day at 2–4 wk intervals (typical dosage = 0.5–2 mcg/day). - PO (Children
5 yr): <1 yr — 0.04–0.08 mcg/kg/day1–5 yr — 0.25–0.75 mcg/day.
Predialysis Patients
- PO (Adults and Children 3 yr): 0.25 mcg/day; if needed, may ↑ dosage up to 0.5 mcg/day.
Rickets
- PO (Adults and Children): Vitamin D-dependent — 1 mcg daily; Vitamin D-resistant — Initial 0.015–0.02 mcg/kg daily; range: 0.03–0.06 mcg/kg daily; maximum dose: 2 mcg daily.
Hypocalcemia in Premature Infants
- PO (Neonates): 1 mcg daily for first 5 days of life.
Therapeutic Classification: vitamins
Pharmacologic Classification: fat soluble vitamins
Absorption: Well absorbed following oral administration.
Distribution: Crosses the placenta and enters breast milk.
Protein Binding: 99.9%.
Metabolism/Excretion: Undergoes enterohepatic recycling and is excreted mostly in bile.
Half-life: 5–8 hr (with normal renal function); 16–22 hr (chronic renal failure).
(effects on serum calcium)
