Parathyroid disease
Initially 1microgram daily (elderly 500nanograms) adjusted to avoid hypercalcaemia; maintenance, usually 0.25-1microgram daily.
Initially 1microgram daily (elderly 500nanograms) adjusted to avoid hypercalcaemia; maintenance, usually 0.25-1microgram daily.
Initially 1microgram daily (elderly 500nanograms) adjusted to avoid hypercalcaemia; maintenance, usually 0.25-1microgram daily.
Initially 1microgram daily (elderly 500nanograms) adjusted to avoid hypercalcaemia; maintenance, usually 0.25-1microgram daily.
Initially 1microgram daily (elderly 500nanograms) adjusted to avoid hypercalcaemia; maintenance, usually 0.25-1microgram daily.
Prescribing Notes:
- If hypercalcaemia occurs, alfacalcidol should be stopped and restarted when plasma calcium is normal (usually within a week).
- Supplemental calcium (usual dose 1-2g daily) may be required in addition to alfacalcidol. Care should be taken to avoid hypercalcaemia. For suitable products see the Hypocalcaemia recommendations in the Nutrition and blood chapter of the formulary.
History Notes
16/02/2022
East Region Formulary content agreed.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Prescribing Notes:
- Cinacalcet is recommended for patients on dialysis who have very high circulating concentrations of parathyroid hormone with or without high calcium concentrations despite other treatments or for whom parathyroidectomy is not appropriate.
- People who receive cinacalcet should have regular checks. Treatment should be stopped if the parathyroid hormone levels in their blood do not fall substantially within 4 months. All monitoring and review related to cinacalcet should be carried out in specialist renal clinics.
- Local guidance can be found on EdRen.
History Notes
03/05/2023
Pathway moved from Hypercalcaemia page to here.
20/04/2023
East Region Formulary content agreed.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
Prescribing Notes:
- The dose should be adjusted according to biochemical monitoring.
- If hypercalcaemia occurs, alfacalcidol should be stopped and restarted when plasma calcium is normal (usually within a week).
- Supplemental calcium may be required in addition to alfacalcidol. Care should be taken to avoid hypercalcaemia. Preparation chosen according to child’s age and ability to take the medication, for suitable products see the Hypocalcaemia recommendations.
History Notes
29/02/2024
East Region Formulary content agreed.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Prescribing Notes:
- Cinacalcet is recommended for patients on dialysis who have very high circulating concentrations of parathyroid hormone with or without high calcium concentrations despite other treatments or for whom parathyroidectomy is not appropriate.
- People who receive cinacalcet should have regular checks. Treatment should be stopped if the parathyroid hormone levels in their blood do not fall substantially within 4 months. All monitoring and review related to cinacalcet should be carried out in specialist renal clinics.
History Notes
29/02/2024
East Region Formulary content agreed.