Hypocalcemia Associated with Hypoparathyroidism or Pseudohypoparathyroidism
- PO (Adults and Children ≥6 yr): 0.25 mcg once daily initially; if needed, may ↑ dose by 0.25 mcg/day at 2–4 wk intervals (typical dosage = 0.5–2 mcg/day).
- PO (Children 1–5 yr): 0.25–0.75 mcg once daily.
- PO (Children <1 yr): 0.04–0.08 mcg/kg once daily.
Secondary Hyperparathyroidism in Chronic Kidney Disease
- PO (Adults ): Patients on dialysis:0.25 mcg once daily; may ↑ by 0.25 mcg/day at 4-8-wk intervals, up to 0.5–1 mcg/day. Patients not on dialysis:0.25 mcg once daily; may ↑ to 0.5 mcg once daily, if needed
- PO (Children >20 kg): Patients not on dialysis:0.25 mcg once daily; adjust dose based on intact parathyroid hormone (iPTH) concentrations.
- PO (Children 10–20 kg): Patients not on dialysis:0.1–0.15 mcg once daily; adjust dose based on iPTH concentrations
- PO (Children <10 kg): Patients not on dialysis:0.05 mcg every other day; adjust dose based on iPTH concentrations
- IV (Adults ): Patients on dialysis:0.5 mcg 3 times weekly; may ↑ by 0.5–1 mcg at 2-4-wk intervals (range: 0.5–4 mcg 3 times weekly).
- PO IV (Children and iPTH >1,000 pg/mL): Patients on dialysis:0.025 mcg/kg 3 times weekly; adjust dose based on iPTH concentrations.
- PO IV (Children and iPTH 501–1,000 pg/mL): Patients on dialysis:0.015 mcg/kg 3 times weekly; adjust dose based on iPTH concentrations.
- PO IV (Children and iPTH 300–500 pg/mL): Patients on dialysis:0.0075 mcg/kg 3 times weekly; adjust dose based on iPTH concentrations.
Rickets
- PO (Adults and Children ): Vitamin D-dependent: 1 mcg once daily; Vitamin D-resistant: 0.015–0.02 mcg/kg once daily (range 0.03–0.06 mcg/kg/day; max = 2 mcg/day).