paricalcitol (Intravenous route)

par-i-KAL-si-tol

Commonly used brand name(s)

In the U.S.

  • Zemplar

Available Dosage Forms:

  • Solution

Therapeutic Class: Antithyroid Agent

Pharmacologic Class: Vitamin D (class)

Uses For paricalcitol

Paricalcitol injection is used to treat and prevent hyperparathyroidism in patients with chronic kidney disease who are on dialysis. Hyperparathyroidism is a condition that is caused when the parathyroid glands located in the neck make too much parathyroid hormone (PTH). This hormone controls the concentrations of calcium and phosphorus in your blood. Paricalcitol helps lower the amount of PTH which lowers the calcium and phosphorus concentrations.

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paricalcitol is available only with your doctor's prescription.

Before Using paricalcitol

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For paricalcitol, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to paricalcitol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of paricalcitol injection in children 5 years of age and older.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of paricalcitol injection in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving paricalcitol, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using paricalcitol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ketoconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of paricalcitol. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone disease or
  • Heart rhythm problems (e.g., arrhythmia) or
  • Hypercalciuria (high calcium in the urine) or
  • Hyperphosphatemia (high phosphate in the blood)—Use with caution. May make these conditions worse.
  • Hypercalcemia (high calcium in the blood) or
  • Vitamin D overdose—Should not be used in patients with these conditions.

Proper Use of paricalcitol

A nurse or other trained health professional will give you paricalcitol in a hospital or dialysis center. paricalcitol is given through a needle placed in one of your veins.

Carefully follow your doctor's instructions about any special diet. Do not use antacids or phosphate binders containing aluminum or supplements containing vitamin D, phosphate, or calcium without asking your doctor.

Your doctor may tell you to limit your dietary intake of phosphate. Foods that are high in phosphate include beans, beer, chocolate, cheese, cola soft drinks, ice cream, milk, nuts, peas, whole grain products, and yogurt.

Precautions While Using paricalcitol

It is very important that your doctor check your progress at regular visits while you are receiving paricalcitol. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood and urine tests may be needed to check for unwanted effects.

paricalcitol may increase the calcium in your blood (hypercalcemia). The symptoms of high calcium may include abdominal or stomach pain; confusion; constipation; depression; dry mouth; headache; incoherent speech; increased urination; loss of appetite; metallic taste; muscle weakness; nausea; thirst; unusual tiredness; vomiting; or weight loss. If you have any of these symptoms, check with your doctor right away.

paricalcitol may increase the aluminum in your blood and may cause harm to your bones if used together with products containing aluminum (eg, antacids or phosphate binders). Ask your doctor before you take any of these medicines.

Do not take other medicines unless they have been discussed with your doctor. Taking other medicines (especially digoxin, Lanoxin®) together with paricalcitol may require your doctor to change the dose of one of the medicines or paricalcitol.

paricalcitol Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common
  • Black, tarry stools
  • bleeding from the rectum or bloody stools
  • chest pain or discomfort
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • swelling of the face, arms, hands, lower legs, or feet
  • unusual bleeding or bruising
  • unusual weight gain
  • vomiting of blood or material that looks like coffee grounds
Rare
  • Abdominal or stomach cramps or pain
  • chills
  • constipation
  • cough
  • depression
  • difficult or labored breathing
  • difficulty with swallowing
  • dry mouth or skin
  • fever
  • inability to speak
  • incoherent speech
  • increased thirst
  • increased urination
  • joint pain
  • loss of appetite
  • metallic taste
  • mood or mental changes
  • muscle aches and pains
  • muscle cramps in the hands, arms, feet, legs, or face
  • muscle spasms or weakness
  • nausea or vomiting
  • numbness and tingling around the mouth, fingertips, or feet
  • pain, redness, or swelling at the injection site
  • pale skin
  • pounding in the ears
  • rapid, shallow breathing
  • severe or sudden headache
  • shivering
  • shortness of breath
  • slurred speech
  • sweating
  • thirst
  • tightness in the chest
  • tingling of the hands or feet
  • tremor
  • trouble thinking
  • troubled breathing with exertion
  • unusual tiredness or weakness
  • weakness in the arm or leg on one side of the body, sudden and severe
  • weight loss
  • wheezing
Incidence not known
  • Blurred vision
  • confusion
  • hoarseness
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • slow or irregular breathing
  • trouble sleeping

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Abdominal or stomach discomfort
  • body aches or pain
  • burning feeling in the chest or stomach
  • burning sensations on the skin
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • burning, dry, or itching eyes
  • change in the color, amount, or odor of vaginal discharge
  • change in walking and balance
  • clumsiness or unsteadiness
  • confusion as to time, place, or person
  • decreased vision
  • difficulty with moving
  • discharge or excessive tearing
  • eye pain
  • hallucinations
  • holding false beliefs that cannot be changed by fact
  • increased hair growth, especially on the face
  • itching skin
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • loss of voice
  • muscle stiffness
  • muscle twitching or jerking
  • night sweats
  • pain in the breasts
  • rash
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • rhythmic movement of the muscles
  • sleeplessness
  • swollen joints
  • tearing
  • unusual excitement, nervousness, or restlessness
Incidence not known
  • Decreased interest in sexual intercourse
  • diarrhea
  • hives or welts
  • inability to have or keep an erection
  • indigestion
  • redness of the skin
  • stomach upset

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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