Side Effects of doxercalciferol: A Synthesis of Findings from 7 Studies

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Original Abstract of the Article

Main Research Findings

Doxercalciferol is a vitamin D analog used to treat secondary hyperparathyroidism, a condition where the parathyroid glands produce too much parathyroid hormone (PTH), often seen in patients with chronic kidney disease. 7 , 2 , 3 , 6 , 5 , 1 , 4 These studies have shown that doxercalciferol can effectively lower PTH levels, but it also carries the risk of raising calcium and phosphorus levels in the blood, which can lead to various side effects.

Reasons for Side Effects

The side effects of doxercalciferol are linked to its mechanism of action, similar to that of natural vitamin D. Doxercalciferol, like vitamin D, promotes calcium absorption from the gut and can also increase calcium release from bones. This can lead to high blood calcium levels (hypercalcemia) and high blood phosphorus levels (hyperphosphatemia) if not carefully monitored. 7 , 2 , 3 , 5

Common Side Effects

Hypercalcemia

Doxercalciferol can lead to hypercalcemia, as it enhances calcium absorption from the intestines. 7 , 3 , 5 Symptoms of hypercalcemia can include loss of appetite, nausea, constipation, and dehydration.

Hyperphosphatemia

Hyperphosphatemia, or elevated phosphorus levels in the blood, can also occur due to doxercalciferol's effect on increasing phosphorus absorption. 7 , 3 , 5 This can interfere with calcium deposition in bones, potentially contributing to osteoporosis and increasing fracture risk. It can also increase the risk of cardiovascular disease.

Other Side Effects

Doxercalciferol can cause other side effects, including headaches, dizziness, nausea, digestive problems, and skin rashes. 7 , 2 , 3 , 6 , 5 , 1 , 4 These side effects are usually mild and resolve when the medication is discontinued, but serious side effects are possible. If you notice any unusual symptoms while taking doxercalciferol, contact your doctor immediately.

Countermeasures for Side Effects

Hypercalcemia

Preventing hypercalcemia involves carefully adjusting the dose of doxercalciferol to minimize the risk of elevated calcium levels. 7 , 3 , 5 Limiting calcium intake through diet is also beneficial. If hypercalcemia develops, intravenous hydration can be used to increase calcium excretion. In some cases, medications may be required to lower calcium levels.

Hyperphosphatemia

The primary approach to preventing hyperphosphatemia is to reduce phosphorus intake through dietary modifications. 7 , 3 , 5 Phosphate binders, medications that block phosphorus absorption in the gut, are also effective in managing hyperphosphatemia.

Comparison Between Studies

Commonalities in Studies

Across several studies, doxercalciferol has demonstrated effectiveness in treating secondary hyperparathyroidism. 7 , 2 , 3 , 6 , 5 , 1 , 4 However, it is consistently observed that doxercalciferol can elevate calcium and phosphorus levels in the blood, posing a risk of hypercalcemia and hyperphosphatemia.

Differences in Studies

The specific details of administration (dose, frequency, route) and the frequency and severity of observed side effects can vary among studies. 7 , 2 , 3 , 6 , 5 , 1 , 4 These differences can be attributed to various factors including the age, gender, health status, type of doxercalciferol administered, dose, method of administration, and duration of the study.

Important Points for Application in Real Life

Doxercalciferol is a valuable medication for treating secondary hyperparathyroidism, but it is crucial to be aware of the potential for hypercalcemia and hyperphosphatemia. 7 , 2 , 3 , 6 , 5 , 1 , 4 If you are prescribed doxercalciferol, strictly follow your doctor's instructions and undergo regular blood tests to monitor your calcium and phosphorus levels to detect and manage any potential side effects.

Limitations of Current Research

The research on the side effects of doxercalciferol is not yet comprehensive. 7 , 2 , 3 , 6 , 5 , 1 , 4 In particular, long-term side effects require further investigation. Additionally, studies on the potential interactions between doxercalciferol's side effects and other medications are lacking.

Future Directions for Research

Further research is needed to better understand the side effects of doxercalciferol. 7 , 2 , 3 , 6 , 5 , 1 , 4 Long-term side effects, interactions with other medications, and the overall safety of doxercalciferol require further study. Research into new therapeutic approaches to minimize doxercalciferol's side effects is also essential.

Conclusion

Doxercalciferol is a valuable treatment for secondary hyperparathyroidism, but its potential for causing hypercalcemia and hyperphosphatemia should be carefully considered. 7 , 2 , 3 , 6 , 5 , 1 , 4 If you are prescribed doxercalciferol, closely follow your doctor's instructions and undergo regular blood tests to monitor calcium and phosphorus levels. This will help to manage any potential side effects and ensure your overall health.

Literature analysis of 7 papers
Positive Content
7
Neutral Content
0
Negative Content
0
Article Type
0
0
0
5
7
1.

Efficacy and side effects of intermittent intravenous and oral doxercalciferol (1alpha-hydroxyvitamin D(2)) in dialysis patients with secondary hyperparathyroidism: a sequential comparison.

Author: MaungH M, ElangovanL, FrazãoJ M, BowerJ D, KelleyB J, AcchiardoS R, RodriguezH J, NorrisK C, SigalaJ F, RutkowskiM, RobertsonJ A, GoodmanW G, LevineB S, ChesneyR W, MazessR B, KylloD M, DouglassL L, BishopC W, CoburnJ W

Reduced hypercalcemia
iPTH suppression
Hyperphosphatemia

Intravenous doxercalciferol (1alphaD(2)) effectively reduced parathyroid hormone levels in hemodialysis patients with secondary hyperparathyroidism. Compared to oral doxercalciferol, intravenous administration resulted in less frequent hypercalcemia and less increase in serum phosphorus levels.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Vitamin D and Its Analogues: From Differences in Molecular Mechanisms to Potential Benefits of Adapted Use in the Treatment of Alzheimer's Disease.

Author: ThielAndrea, HermannsCarina, LauerAnna Andrea, ReichrathJörg, ErhardtTobias, HartmannTobias, GrimmMarcus Otto Walter, GrimmHeike Sabine

Alzheimer's treatment

This review discusses the importance of adequate vitamin D levels in older adults, especially those with Alzheimer's disease (AD). It summarizes the effects of different vitamin D analogues on AD and common comorbidities in the elderly.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Vitamin D metabolites and/or analogs: which D for which patient?

Author: MazzaferroS, GoldsmithD, LarssonT E, MassyZ A, CozzolinoM

Corrected vitamin D deficiency
Improved bone disease
Suppressed parathyroid activity
Hypercalcemia

This paper reviews the characteristics and potential clinical indications of various vitamin D drugs, focusing on renal patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

New vitamin D analogs and changing therapeutic paradigms.

Author: CunninghamJohn, ZehnderDaniel

Cardiovascular benefits
Vitamin D treatment
Calcium and phosphate increase

The study found that selective vitamin D compounds with minimal effects on mineral metabolism and with maximal cardiovascular and renal benefits are needed. Current clinical use of vitamin D compounds is limited to paricalcitol, 22-oxacalcitriol, and doxercalciferol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

A review of intravenous versus oral vitamin D hormone therapy in hemodialysis patients.

Author: MazessR B, ElangovanL

Treat hyperparathyroidism
Small study size

This review examines 21 clinical trials comparing intravenous (i.v.) and oral vitamin D analogs for the treatment of secondary hyperparathyroidism in hemodialysis patients. It highlights the limitations of the studies, particularly their small size, and calls for further research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Vitamin D analogues for the management of secondary hyperparathyroidism.

Author: MartinK J, GonzálezE A

PTH suppression
Wider therapeutic window
Hypercalcemia
Hyperphosphatemia

This article discusses secondary hyperparathyroidism complicating chronic kidney disease. Therapy with calcitriol is effective, but side effects like hypercalcemia and hyperphosphatemia can complicate treatment. Vitamin D analogs, like paricalcitol and doxercalciferol, are being investigated as potential alternatives that may offer a wider therapeutic window.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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