doxercalciferol injection Drug Interactions

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7 DRUG INTERACTIONS

Table 2 includes clinically significant drug interactions with doxercalciferol.

Table 2: Clinically Significant Drug Interactions with Doxercalciferol
Drugs that May Increase the risk of Hypercalcemia
Clinical ImpactConcomitant administration of high doses of calcium-containing preparations or other vitamin D compounds may increase the risk of hypercalcemia. Thiazide diuretics are known to induce hypercalcemia by reducing excretion of calcium in the urine.
ExamplesCalcium-containing products, other vitamin D compounds or thiazide diuretics
InterventionMonitor serum calcium concentrations more frequently and adjust Doxercalciferol Injection dose as needed [see Warnings and Precautions (5.1)].
Digitalis Compounds
Clinical ImpactDoxercalciferol can cause hypercalcemia which can potentiate the risk of digitalis toxicity.
InterventionMonitor patients for signs and symptoms of digitalis toxicity and increase frequency of serum calcium monitoring when initiating or adjusting the dose of Doxercalciferol Injection in patients receiving digitalis compounds [see Warnings and Precautions (5.2)].
Cytochrome P450 Inhibitors
Clinical ImpactDoxercalciferol is activated by CYP 27 in the liver. Cytochrome P450 inhibitors may inhibit the 25-hydroxylation of doxercalciferol and thus reduce the formation of active doxercalciferol moiety [see Clinical Pharmacology (12.3)].
ExamplesKetoconazole and erythromycin
InterventionIf a patient initiates or discontinues therapy with a cytochrome P450 inhibitor, dose adjustment of Doxercalciferol Injection may be necessary. Monitor intact PTH and serum calcium concentrations closely.
Enzyme Inducers
Clinical ImpactDoxercalciferol is activated by CYP 27 in the liver. Enzyme inducers may affect the 25-hydroxylation of doxercalciferol [see Clinical Pharmacology (12.3)].
ExamplesGlutethimide and phenobarbital
InterventionIf a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of Doxercalciferol Injection may be necessary. Monitor intact PTH and serum calcium concentrations closely.
Magnesium-containing Products
Clinical ImpactConcomitant administration of Doxercalciferol Injection and high doses of magnesium-containing products may increase the risk of hypermagnesemia.
ExamplesMagnesium-containing products such as antacids
InterventionAvoid use of magnesium-containing products and Doxercalciferol Injection.

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Drug Interactions

7 DRUG INTERACTIONS

Table 2 includes clinically significant drug interactions with doxercalciferol.

Table 2: Clinically Significant Drug Interactions with Doxercalciferol
Drugs that May Increase the risk of Hypercalcemia
Clinical ImpactConcomitant administration of high doses of calcium-containing preparations or other vitamin D compounds may increase the risk of hypercalcemia. Thiazide diuretics are known to induce hypercalcemia by reducing excretion of calcium in the urine.
ExamplesCalcium-containing products, other vitamin D compounds or thiazide diuretics
InterventionMonitor serum calcium concentrations more frequently and adjust Doxercalciferol Injection dose as needed [see Warnings and Precautions (5.1)].
Digitalis Compounds
Clinical ImpactDoxercalciferol can cause hypercalcemia which can potentiate the risk of digitalis toxicity.
InterventionMonitor patients for signs and symptoms of digitalis toxicity and increase frequency of serum calcium monitoring when initiating or adjusting the dose of Doxercalciferol Injection in patients receiving digitalis compounds [see Warnings and Precautions (5.2)].
Cytochrome P450 Inhibitors
Clinical ImpactDoxercalciferol is activated by CYP 27 in the liver. Cytochrome P450 inhibitors may inhibit the 25-hydroxylation of doxercalciferol and thus reduce the formation of active doxercalciferol moiety [see Clinical Pharmacology (12.3)].
ExamplesKetoconazole and erythromycin
InterventionIf a patient initiates or discontinues therapy with a cytochrome P450 inhibitor, dose adjustment of Doxercalciferol Injection may be necessary. Monitor intact PTH and serum calcium concentrations closely.
Enzyme Inducers
Clinical ImpactDoxercalciferol is activated by CYP 27 in the liver. Enzyme inducers may affect the 25-hydroxylation of doxercalciferol [see Clinical Pharmacology (12.3)].
ExamplesGlutethimide and phenobarbital
InterventionIf a patient initiates or discontinues therapy with an enzyme inducer, dose adjustment of Doxercalciferol Injection may be necessary. Monitor intact PTH and serum calcium concentrations closely.
Magnesium-containing Products
Clinical ImpactConcomitant administration of Doxercalciferol Injection and high doses of magnesium-containing products may increase the risk of hypermagnesemia.
ExamplesMagnesium-containing products such as antacids
InterventionAvoid use of magnesium-containing products and Doxercalciferol Injection.
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