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Paricalcitol
Paricalcitol is a synthetic vitamin D analog used primarily for the management of secondary hyperparathyroidism in patients with chronic kidney disease (CKD). It helps to regulate calcium and phosphate metabolism, thereby reducing elevated parathyroid hormone (PTH) levels and helping to prevent complications associated with CKD.
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Frequently Asked Questions
How quickly does paricalcitol work?
Patients may start to see improvements in PTH levels within a few weeks of starting treatment, but optimal effects may take longer.
Can I take paricalcitol with food?
Yes, paricalcitol can be taken with or without food, but consistency in administration is important.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it's close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double up.
Is paricalcitol safe during pregnancy?
Paricalcitol should be used during pregnancy only if the potential benefits justify the potential risks. Consult your healthcare provider for guidance.
What are the signs of serious side effects to watch for?
Monitor for symptoms of hypercalcemia (such as nausea, vomiting, or confusion) and seek immediate medical attention if these occur.
Comprehensive Drug Guide
How Does Paricalcitol Work?
Paricalcitol works by activating vitamin D receptors in the body, which leads to increased intestinal absorption of calcium and phosphate. This action helps to suppress PTH secretion by the parathyroid glands, thereby reducing the risk of bone disease and other complications associated with elevated PTH levels.
Common Dosages
- Capsules: 1 mcg, 2 mcg, and 4 mcg.
- Injection: 1 mcg/mL.
Typical Dosing
- Adults with CKD: The usual starting dose is 1 to 2 mcg orally three times a week, adjusted based on PTH levels and patient response. Doses may be increased gradually based on serum calcium and phosphorus levels.
Typical Dosing
FDA Approved Indications
- Treatment of secondary hyperparathyroidism in patients with chronic kidney disease on dialysis or with stage 5 CKD.
Who Shouldn't Take Paricalcitol?
- Known hypersensitivity to paricalcitol or any component of the formulation
- Hypercalcemia (elevated calcium levels)
Advice From The Pharmacist
- Take paricalcitol exactly as prescribed, and do not exceed the recommended dose.
- Regular monitoring of serum calcium, phosphorus, and PTH levels is important to ensure safe and effective treatment.
- Report any signs of hypercalcemia, such as nausea, vomiting, constipation, or confusion, to your healthcare provider immediately.
Side Effects of Paricalcitol
Common Side Effects
- Nausea
- Headache
- Weakness
- Injection site reactions (if given as an injection)
Uncommon/Severe Side Effects
- Hypercalcemia
- Hyperphosphatemia
- Allergic reactions (rash, itching, swelling)
Risks and Warnings of Paricalcitol
- Monitoring: Regular monitoring of calcium and phosphate levels is essential to avoid complications from treatment.
- Hypercalcemia: Be vigilant for signs of hypercalcemia, and consult your healthcare provider if symptoms occur.
Interactions with Paricalcitol
Common Drug Interactions
- Calcium Supplements: Use caution when combining with calcium-containing products, as this may increase the risk of hypercalcemia.
- Other Vitamin D Products: Avoid concurrent use of other vitamin D analogs to prevent excessive vitamin D levels.
Alternatives to Paricalcitol
- Other Vitamin D Analogues: Such as calcitriol or doxercalciferol for similar indications.
- Phosphate Binders: Such as sevelamer or calcium acetate to manage phosphorus levels in CKD patients.