Guidelines for Complications of Cancer Treatment Vol VIII Part B

Goal – To raise serum calcium levels by 2-3mg/dL withadministration of 15mg/kg elemental calcium over 4-6hrs. Serum calcium 7mg/dL – Oral supplements with elemental calcium15mg/kg/day (calcium carbonate 1-3g/day).Vitamin D3: Commonly used - Calcitriol - 0.25-0.5mgup to four times daily.Ergocalciferol – less expensive, longer durationof action - 50,000 – 100000 IU/Day. If administration of therapy is needed acutely,Calcitriol should be administered for first threeweeks and then tapered off as the dose ofergocalciferol becomes effective.Diet rich in calcium is advisedRegular follow up: Serum calcium evaluation every 3-6months. Evaluation of serum calcium is important as excessivecalcium consumption may lead to hypercalciuria withnephrocalcinosis and/or nephrocalcinosis, hence it ismandatory to monitor calcium annually with 24hr urinecalcium (