Severe hypocalcemia with tetany requires intravenous administration of calcium under careful electrocardiographic monitoring, followed by oral vitamin D. In milder forms, calcitriol is the drug of choice, because of its short half-life and rapid action. A dosage of 0.25-1 μg twice daily is usually sufficient to normalize calcium and phosphate. Because of the risk of hypercalcemia and hypercalciuria, serum calcium level and 24-hour urinary calcium and phosphate measurements should be carefully monitored, especially at the beginning of treatment and if elevated doses of Vitamin D are administered.
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