Paricalcitol: Uses, Recommendations, Side Effects, Dosage and Interactions

It is a synthetic form of vitamin D (essential vitamin for the absorption of calcium, and in general, for calcium in the body).

This medication is used to prevent or treat hyperparathyroidism (overactive parathyroid gland) in people with chronic kidney disease.

Paricalcitol has other uses as well.

Important information about paricalcitol

If you have high levels of calcium ( hypercalcaemia ) or vitamin D in your body , you should not take paricalcitol.

Before you start taking paricalcitol

Do not take paricalcitol before making sure you are not allergic to the medicine. To check that the medicine is safe, discuss with your doctor if you have:

  • Electrolyte imbalance (such as low levels of potassium or magnesium in the blood).
  • Liver disease.
  • High blood pressure.

Paricalcitol is not approved for use by anyone under the age of 10.

Paricalcitol and pregnancy

It is not known whether this medicine will harm an unborn baby. You should discuss the consumption of paricalcitol with your doctor if you are pregnant or planning to have a baby.

Paricalcitol and breastfeeding

It is not known if this medicine can pass into breast milk. For this reason, you should not breastfeed while taking paricalcitol.

How should paricalcitol be taken?

Follow the directions on the prescription label and the orders your doctor gives you. Do not change the dose without your doctor’s supervision before.

Paricalcitol is sometimes taken every day, and sometimes it is taken every other day or 3 times a week. Paricalcitol can be consumed with food, although it is not mandatory.

Paricalcitol can be just part of a complete treatment program that also includes a special diet. Familiarize yourself with the list of foods to avoid to help manage your condition.

While using paricalcitol, you may need frequent blood tests.

What should be avoided while taking paricalcitol?

  • Do not take other vitamin or mineral supplements (including mineral oil), unless your doctor has told you to.
  • Avoid ingesting mineral oil or cholestyramine within 1 hour after or 4-6 hours before consuming paricalcitol.
  • Avoid consuming grapefruit, grapefruit juice or grapefruit products, the combination of the drug plus the properties of the fruit can cause unwanted effects on the body.
  • If you do not have your doctor’s advice or have not discussed the effects that paricalcitol may have, do not take antacids or calcium supplements.

Side effects of paricalcitol

If you have any of the following symptoms (symptoms of an allergic reaction), seek emergency help:

  • Swelling of the face, lips, throat and / or tongue.
  • Hives
  • Difficulty breathing.

Contact your doctor immediately and stop using paricalcitol if you experience these symptoms:

  • Pains in the body
  • Fever.
  • Shaking chills.
  • Pain or burning when urinating.
  • High levels of vitamin D in the body: metallic taste in the mouth, weight loss, constipation, nausea, vomiting, weakness and muscle or bone pain.
  • High levels of calcium in the body: tiredness, feeling restless, loss of appetite and weight, constipation, nausea and vomiting.

Common side effects can include:

  • Nausea and vomiting
  • Dizziness
  • Diarrhea.
  • Sinus pain
  • Throat pain.
  • Increase in blood pressure that generates: palpitations in the neck or ears, anxiety, headaches, blurred vision.

Paricalcitol Dosage Information

Usual Adult Dose for Secondary Hyperparathyroidism:

Injectable:

  • Starting dose: 0.04 to 0.1 mcg / kg (2.8 to 7 mcg), injected as a bolus dose through a hemodialysis vascular access port at any time during dialysis
  • Maximum frequency: every two days
  • Do not inject directly into a vein.
  • Use: prevention and treatment of secondary hyperparathyroidism associated with Stage 5 chronic kidney disease.

Oral:

  • Starting dose:  Stage 3 or 4 Chronic kidney disease (CKD): Starting dose is based on reference intact parathyroid hormone (iPTH): 500 pg / ml or less: 1 mcg orally every day OR 2 mcg orally oral 3 times a week. More than 500 pg / ml: 2 mcg orally OR 4 mcg orally 3 times a week.

Etapa 5 CKD:

  • Starting dose (micrograms) : baseline iPTH level (pg / ml) / 80
  • Starting dose given orally 3 times per week –  Only start if baseline serum calcium has been adjusted to 9.5 mg / dL or less. If this dose is given 3 times a week, do not do it more often than every other day.
  • Use: prevention and treatment of secondary hyperparathyroidism associated with: chronic kidney disease (CKD) stages 3 and 4 (oral product only), or CPK kidney stage 5 on hemodialysis or peritoneal dialysis (oral or injectable).

Usual pediatric dose for secondary hyperparathyroidism:

Safety and efficacy have not been established in pediatric patients. The following is the dose used in a very small pediatric trial. No data are available on children under 5 years of age.

Starting dose, children 5 to 18 years:

  • 0.04 mcg / kg three times a week if baseline intact parathyroid hormone (iPTH) is less than 500 pg / mL
  • 0.08 mcg / kg three times a week if initial HTP is 500 pg / mL or higher
  • It is injected as a bolus dose through a hemodialysis vascular access port at any time during dialysis.
  • Maximum frequency: every two days.
  • Do not inject directly into a vein.
  • Use: prevention and treatment of secondary hyperparathyroidism associated with Stage 5 chronic kidney disease.

What other medicines can affect paricalcitol?

Consult with your doctor about any other medications you take if you are taking paricalcitol, especially:

  • Nefazodona.
  • Digozina.
  • Conivaptan.
  • An antibiótico:  clarithromycin, telithromycin.
  • Ketoconazole, pvoriconazole, posaconazole, itraconazole (antifungal medicine).
  • Telaprevir, fosamprenavir, lopinavir, boceprevir, indinavir, nelfinav, cobicistat, saquinavir, ritonavir (antiviral medicines used to treat HIV or AIDS and hepatitis C).