Drug Interaction Report
1 drug interaction and 7 additional warnings found for the following 2 drugs:
- paricalcitol
- trofinetide
Drug interactions
Moderate drug interactions
Moderate:paricalcitol trofinetide
Applies to: paricalcitol, trofinetide
Trofinetide may increase the blood levels and effects of paricalcitol.
Talk to your doctor if you have any questions or concerns.
You may need more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:Food/Lifestyle paricalcitol
Applies to: paricalcitol
Treatment with paricalcitol may require you to adjust your dietary intake of foods which contain natural or added calcium, phosphate (organic and inorganic), and vitamin D or grapefruit.
Ingesting too much vitamin D or having elevated calcium and/or phosphorus levels in the blood and urine can lead to toxic effects, such as:
- having an irregular heart rhythm
- seizures
- kidney stones
- eventual calcification of your blood vessels, cornea and/or the soft tissues in your body
Consumption of grapefruit and grapefruit juice may also alter the blood levels and effects of paricalcitol.
Your doctor will monitor the levels of calcium and phosphorus in your blood during treatment with paricalcitol. Please speak with your healthcare team to determine if you require a specialized diet, particularly if you have reduced kidney function, and to discuss any other questions or concerns you have. You may require additional monitoring or a dose adjustment of paricalcitol if your diet changes.
Fortified foods will state on their labeling how much calcium, phosphate, and/or vitamin D has been added. The National Institutes of Health, Office of Dietary Supplements also provides information on which foods contain calcium, phosphorus, and vitamin D.
You should avoid abrupt changes in your dietary calcium intake and seek medical attention if you experience early symptoms of vitamin D intoxication such as:
- weakness
- fatigue
- headache
- drowsiness
- vertigo
- ringing in the ears
- loss of appetite
- nausea
- vomiting
- constipation
- dry mouth
- metallic taste
- muscle pain
- bone pain
- muscle incoordination
- low muscle tone
Late symptoms may include:
- frequent urination
- excessive thirst
- weight loss
- conjunctivitis ("pink eye")
- light sensitivity
- runny nose
- itching
- increased body temperature
- irregular heart rhythm
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
6 potential interactionsApplies to: 6 conditions, including Arrhythmia, Liver Disease, Hypercalcemia, Malabsorption Syndrome, and Biliary Obstruction.
Arrhythmia
Major:paricalcitol
Paricalcitol has a major potential interaction with Arrhythmia.
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. .
Biliary Obstruction
Moderate:paricalcitol
Paricalcitol has a moderate potential interaction with Biliary Obstruction.
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.
Hypercalcemia
Major:paricalcitol
Paricalcitol has a major potential interaction with Hypercalcemia.
Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.
Liver Disease
Moderate:paricalcitol
Paricalcitol has a moderate potential interaction with Liver Disease.
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.
Malabsorption Syndrome
Major:paricalcitol
Paricalcitol has a major potential interaction with Malabsorption Syndrome.
Vitamin D analogs such as calciferol and ergocalciferol should not be given to patients with hypercalcemia, malabsorption syndrome, or evidence of vitamin D toxicity.
Phosphate Imbalance
Moderate:paricalcitol
Paricalcitol has a moderate potential interaction with Phosphate Imbalance.
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.
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Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
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Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.