<p>Usual Adult Dose for Secondary Hyperparathyroidism:</p>

<p>Initial dose:<br />
<br />
<strong>Stage 3 or 4 Chronic Kidney Disease (CKD)</strong>: Initial dosing is based on baseline intact parathyroid hormone (iPTH):</p>

<ul>
	<li>500 pg/mL or less: 1 mcg orally daily OR 2 mcg orally 3 times a week</li>
	<li>Over 500 pg/mL: 2 mcg orally daily OR 4 mcg orally 3 times a week</li>
</ul>

<p><strong>Stage 5 Chronic Kidney Disease (CKD)</strong>:</p>

<ul>
	<li>Starting dose (micrograms) = baseline iPTH level (pg/mL)/80</li>
	<li>Starting dose is given orally 3 times a week; only start if baseline serum calcium has been adjusted to 9.5 mg/dL or lower.</li>
</ul>

<p><br />
Usual Pediatric Dose for Secondary Hyperparathyroidism:</p>

<p>Safety and efficacy have not been established in pediatric patients. The following is dosing used in a very small pediatric trial. No data are available on children under 5 years old.<br />
<br />
<strong>Initial dose, children 5 to 18 years</strong>: 0.04 mcg/kg three times per week if baseline intact parathyroid hormone (iPTH) is less than 500 pg/mL 0.08 mcg/kg three times per week if baseline iPTH is 500 pg/mL or higher. Injected as a bolus dose through a hemodialysis vascular access port at any time during dialysis<br />
<br />
Maximum frequency: Every other day</p>