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Hectorol
Injection Prescribing Information
Hectorol
Capsules Prescribing Information
Patients For U.S. Residents Only

Mechanism of Action

  • Hectorol®:
    a prodrug1,2,3

    Prodrugs are compounds that require chemical conversion by metabolic processes before they become an active pharmacological agent.4 Hectorol is a synthetic vitamin D2 analog that gets converted to a biologically active form of vitamin D2 in vivo, without the involvement of the kidneys, to help regulate iPTH serum levels in patients with CKD.5,6 Doxercalciferol, the active ingredient in Hectorol, is inert until activated by the liver, making it a prodrug.2,3

    The consequence of in vivo activation of Hectorol is the release of the major metabolite of doxercalciferol (1α,25-[OH]2D2) with a mean elimination half-life of approximately 32 to 37 hours.7,8

How is active
vitamin D formed?

1. Person without CKD

Inactive vitamin D comes from dietary sources and from the exposure of skin to sunlight. It is activated by the liver and kidneys to form active vitamin D.9

Skin exposed to sunlight helps create Vitamin D + The liver helps convert sunlight into Vitamin D + Kidneys help convert sunlight into active Vitamin D = Active
vitamin D


2. Person with CKD

Inactive vitamin D provided by Hectorol is activated by the liver, without the need for activation by the kidneys, to form active vitamin D.9

Learn more about Hectorol® (injection) + The liver helps convert sunlight into Vitamin D + Hectorol® (injection) doesn’t need the kidneys to produce active Vitamin D. = Active
vitamin D

Contact Us

Contact Hectorol® for more informationSanofi US
500 Kendall Street
Cambridge, MA 02142
Contact Hectorol® for more informationToll free: 800-847-0069 Contact Hectorol® for more informationFax: 617-591-5986

Indication

  • Hectorol Injection is indicated for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis.
  • Hectorol capsules are indicated for the treatment of secondary hyperparathyroidism in patients with Stage 3 or Stage 4 chronic kidney disease not on dialysis and patients with chronic kidney disease on dialysis.

Important Safety Information

  • Hectorol is contraindicated in patients with a tendency towards hypercalcemia, or evidence of vitamin D toxicity.
  • Hectorol injection is contraindicated in patients with previous hypersensitivity to doxercalciferol or any of its ingredients.
  • Overdosage of any form of vitamin D is dangerous and may lead to progressive hypercalcemia, which if severe, may require emergency attention.
  • Acute hypercalcemia may exacerbate tendencies for cardiac arrhythmias and seizures and may potentiate the action of digitalis drugs.
  • Chronic hypercalcemia can lead to generalized vascular and other soft tissue calcification.
  • Pharmacologic doses of vitamin D and its derivatives should be withheld during Hectorol treatment to avoid possible additive effects and hypercalcemia.
  • The patient should be informed about adherence to instructions about diet, calcium supplementation, and avoidance of the use of nonprescription drugs without prior physician approval. Patients should also be carefully informed about the symptoms of hypercalcemia such as weakness, headache, drowsiness, nausea, vomiting, dry mouth, constipation, muscle pain, bone pain, metallic taste and loss of appetite.
  • Uncontrolled serum phosphorus in patients undergoing dialysis may lessen the effectiveness of Hectorol.
  • Magnesium-containing antacids and Hectorol should not be administered concomitantly.
  • Serious hypersensitivity reactions, including fatal outcome, have been reported post marketing in patients on hemodialysis following administration of Hectorol Injection. Hypersensitivity reactions include anaphylaxis with symptoms of angioedema (involving face, lips, tongue and airways), hypotension, unresponsiveness, chest discomfort, shortness of breath, and cardiopulmonary arrest. These reactions may occur separately or together
  • Monitor patients receiving Hectorol Injection upon initiation of treatment for hypersensitivity reactions. Should a hypersensitivity reaction occur, discontinue Hectorol, monitor and treat if indicated
  • Patients should be checked and treated for nutritional vitamin D deficiency prior to initiating treatment with Hectorol capsules.
  • Cholestyramine may impair intestinal absorption of doxercalciferol capsules.
  • Enzyme inducers may affect the 25-hydroxylation of Hectorol and may necessitate dosage adjustments. Cytochrome P450 inhibitors may inhibit the 25-hydroxylation of Hectorol. Formation of the active Hectorol moiety may be hindered.
  • Adverse effects of Hectorol injection treatment are: hypercalcemia, hyperphosphatemia, and oversuppression of iPTH. Adverse effects of Hectorol capsules treatment are hypercalcemia, hyperphosphatemia, hypercalciuria, and oversuppression of PTH. These should be managed by regular patient monitoring and appropriate dosage adjustments.
  • Serum levels of iPTH, calcium and phosphorus should be determined prior to initiation of Hectorol treatment. During the early phase of treatment they should be determined weekly.
  • Adverse events reported by ≥5% of the Hectorol-treated dialysis patients included: edema, headache, malaise, nausea/vomiting, dizziness, dyspnea, pruritus and bradycardia.
  • Adverse events occurring at a frequency of ≥5% in patients taking Hectorol capsules with Stage 3 or Stage 4 chronic kidney disease not on dialysis were infection, chest pain, constipation, dyspepsia, anemia, dehydration, depression, hypertonia, insomnia, paresthesia, increased cough, dyspnea and rhinitis.
  • This drug should be used during pregnancy only if clearly needed.
  • Nursing mothers should discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
  • This drug should be used with caution in patients with impaired hepatic function.

Please click here for Hectorol Capsules Full Prescribing Information or click here for Hectorol Injection Full Prescribing Information.

References:
  1. Merriam-Webster dictionary/”prodrug”
  2. Hectorol Injection PI/p 1/col 1/Pharmacokinetics
  3. Hectorol Capsules PI/p 1/col 1/Pharmacokinetics
  4. Dorland’s Med. Dictionary 31st ed./p 1545/col 1/”prodrug”
  5. Hectorol Injection PI/p 1/col 1/para 1/para 5/col 2/para 1
  6. Hectorol Capsules PI/p 1/col 1/para 1/col 2/table 1/col 3/para 3,4
  7. Hectorol Capsules PI/p 1/col 1/para 5
  8. Hectorol Injection PI/p 1/col 1/para 5,6
  9. Welcome to Hectorol: US.DOX.13.12.001

Contact Us

Contact Hectorol® for more informationSanofi US
500 Kendall Street
Cambridge, MA 02142
Contact Hectorol® for more information Toll Free: 800-847-0069 Contact Hectorol® for more information Fax: 617-591-5986

IMPORTANT SAFETY INFORMATION
Hectorol is contraindicated in patients with a tendency towards hypercalcemia, or evidence of vitamin D toxicity. VIEW MORE