Hypocalcemia Surveillance, Total Thyroidectomy — Calcitriol Dosing (1,25-Dihydroxy Vitamin D3) — Clinical Pathway: Inpatient and Outpatient Specialty Care

Thyroidectomy Calcium Management Clinical Pathway — Inpatient and Outpatient Specialty Care

Calcitriol Dosing (1,25-Dihydroxy Vitamin D3) and
Paricalcitol Dosing

General Information

  • Monitor calcium and phosphorus every 6 hrs
  • Wean calcitriol to recommended dosing range as calcium normalizes
  • Contact Endocrinology with symptomatic hypocalcemia or calcium less than 8.5 mg/dL
  • Calcitriol clinical effect lags behind dose adjustment

Calcitriol Drug Characteristics

  • Readily absorbed, with peak serum levels at 3-6 hrs with oral administration
  • Mean serum half-life not well-studied — may be as long as 27 hrs
  • Steady state level is reached within 7 days, after multiple doses

Calcitriol Dosing PO

Infants 0.04-0.08 mcg/kg/day divided twice daily
Children < 30 kg 0.25-0.5 mcg/dose twice daily
Children and Adults ≥ 30 kg 0.5-1.0 mcg/dose twice daily

Calcitriol Dosing IV

To be used for single dose prior to initiation of PO.

< 5 yrs 0.25 mcg x 1 dose
5-10 yrs 0.5 mcg x 1 dose
> 10 yrs 1-2 mcg x 1 dose

Alternative Medication: Paricalcitol Dosing IV

Only to be used if IV Calcitriol is not available.
To be used for single dose prior to initiation of PO calcitriol.

< 2 yrs Not recommended
≥ 2 yrs and < 30 kg 0.75 mcg to 1 mcg x 1 dose
Children and Adults ≥ 30 kg 1.5 mcg to 4 mcg x 1 dose