Secondary hyperparathyroidism in patients undergoing maintenance dialysis. Hypercalcemia patients w/ parathyroid carcinoma. Hypercalcemia patients w/ primary hyperparathyroidism who are unable to undergo parathyroidectomy or relapse after parathyroidectomy.
Secondary hyperparathyroidism Initially 25 mg once daily, may be adjusted to 25-75 mg once daily. Increase dose by 25 mg at 3-wk intervals up to 100 mg once daily if required or if there is no improvement on the parathyroid hormone (PTH). Primary hyperparathyroidism Initially 25 mg bd, may be adjusted to 25-75 mg bd. Increase dose by 25 mg at 2-wk intervals up to 75 mg tds or qds.
Determine serum Ca & PTH level prior to & periodically during therapy. Decrease dose as needed if serum Ca level is ≤8.4 mg/dL or w/draw if ≤7.5 mg/dL. Hypocalcaemia, seizure, hepatic dysfunction, GI hemorrhage &/or ulcer. Patients not on dialysis. Adynamic bone disease, hungry bone syndrome. Pregnancy & lactation. Infant, childn, elderly.
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