Paricalcitol Disease Interactions

Paricalcitol, a vitamin D analog, reduces hyperparathyroidism associated with chronic renal failure without significant increase in serum calcium levels. Serum calcium and phosphate concentrations can increase during therapy with paricalcitol and may exacerbate arrhythmias, particularly in patients receiving cardiac glycosides. Therapy with vitamin D analogs should be administered cautiously in patients with or predisposed to cardiac arrhythmias. Clinical monitoring of serum electrolyte concentrations and cardiac function is recommended. .

Vitamin D analogs administered in the presence of hyperphosphatemia can result in precipitation of calcium-phosphate deposits within the vascular or renal systems or other soft tissue calcifications. A solubility product (Serum Calcium X Phosphate) should not exceed 70. Serum electrolyte concentrations should be corrected prior to vitamin D analog therapy and monitored during therapy.

Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.

Paricalcitol is metabolized by the liver. Parent compound and metabolites are primarily eliminated by in the bile and feces. Paricalcitol metabolites have not been characterized or identified. Metabolic and therapeutic activity of paricalcitol may be altered in patients with hepatic impairment. Therapy with paricalcitol should be administered cautiously in patients with hepatobiliary dysfunction. Clinical monitoring of hepatobiliary function, parathyroid hormone and calcium levels is recommended.