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Reyaldee is an **extended-release oral formulation of calcifediol**, the 25-hydroxyvitamin D3 prohormone and immediate precursor of calcitriol. It was developed to gradually raise serum 25-hydroxyvitamin D levels and thereby reduce elevated parathyroid hormone in adults with **secondary hyperparathyroidism associated with stage 3 or 4 chronic kidney disease and vitamin D insufficiency**. After hepatic-type vitamin D replacement with calcifediol, the endogenous pathway converts it to active 1,25-dihydroxyvitamin D, which activates the vitamin D receptor and suppresses parathyroid hormone synthesis and secretion while affecting calcium and phosphate homeostasis. Reyaldee was developed and commercialized by OPKO and is marketed as an oral extended-release capsule approved in the United States.
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