Paricalcitol (Intravenous)

Paricalcitol helps to lower the calcium and phosphorous levels in patients who are being treated for chronic kidney disease.

Overview

Paricalcitol is a treatment used in patients who are being treated for chronic kidney disease and are receiving dialysis. It is used to prevent and treat the occurrence of hyperthyroidism in these patients.

Hyperthyroidism is a condition in which the parathyroid glands produce the hormone parathyroid in too great doses. The hormone is normally used to control calcium and phosphorous levels in the blood.

Paricalcitol works to prevent the production of PTH and lower the levels of phosphorous and calcium in the blood of the patient. In doing so hyperthyroidism can be prevented and treated in patients who are undergoing dialysis.

This medication is only available with a prescription and is administered as an injection of Zemplar directly into the veins of the patient.

Condition treated

  • Hyperthyroidism, with chronic kidney disease

Type Of Medicine

  • Vitamin D

Side Effects

Paricalcitol can have a range of unwanted side effects in addition to the desired effects of preventing and treating hyperthyroidism. While not all of these side effects may occur, where they do you may need to seek immediate medical attention.

You must check with your nurse or doctor immediately if you experience any of these side effects from treatment with the medication:

Occurring less commonly:

  • Black stools with a tarry appearance
  • Bleeding from the rectum
  • Bloody stools
  • Changed heartbeat or pulse
  • Chest discomfort
  • Chest pains
  • Fainting or faintness
  • Irregularity of heartbeat or pulse
  • Lightheadedness or dizziness when rising from a sitting or lying position
  • Swelling of the face, arms, hands, feet or lower legs
  • Unusual bleeding
  • Unusual bruising
  • Unusual weight gain
  • Vomiting a material with the appearance of coffee grounds
  • Vomiting of blood

Occurring only rarely:

  • Abdominal cramping or pain
  • Changed mood
  • Chills when warm
  • Constipation
  • Coughing
  • Depression
  • Difficult or labored breathing
  • Difficulty with swallowing
  • Dryness of the mouth
  • Dryness of the skin
  • Feverishness
  • Inability to communicate normally
  • Incoherence of speech
  • Increased frequency of urination
  • Increased thirstiness
  • Joint pains
  • Loss of appetite
  • Mental changes
  • Metallic taste in mouth
  • Muscle aches
  • Muscle cramps in the hands, arms, feet, legs or face
  • Muscle pains
  • Muscle spasms
  • Muscle weakness
  • Nausea
  • Numbness and tingling around the mouth, fingertips and feet
  • Pain, redness and/or swelling at the injection site
  • Paleness of the skin
  • Pounding in the ears
  • Rapid and shallow breathing
  • Severe or suddenly occurring headache
  • Shivering when warm
  • Shortness of breath
  • Slurring of speech
  • Stomach cramps or pain
  • Sweating
  • Thirstiness
  • Tightness in the chest
  • Tingling of the hands or feet
  • Tremors
  • Trouble with thinking
  • Troubled breathing when exerting oneself
  • Unusual tiredness
  • Unusual weakness
  • Vomiting
  • Weakness in the arm or leg down a single side of the body
  • Weight loss
  • Wheezing

Frequency of incidence not known

  • Blurring of vision
  • Confusion
  • Hoarseness
  • Slowed or irregular breathing
  • Swellings appearing on the:
    • Tongue
    • Throat
    • Sex organs
    • Lips
    • Legs
    • Hands
    • Feet
    • Face
    • Eyelids
  • Troubled sleep

Paricalcitol may also cause other unwanted side effects to occur that are less serious and do not indicate a wider medical problem. These side effects will usually abate over time as the body becomes used to the medication. If these effects do become bothersome or are ongoing, however, then you can consult your healthcare professional on how best to alleviate them. These side effects would not normally necessitate that you sought advice from a doctor:

Occurring less commonly:

  • Abdominal pain
  • Body aches
  • Body pain
  • Burning feeling in the chest and/or stomach
  • Burning or tingling of the skin
  • Burning sensations of the skin
  • Burning, dryness or itching of the eyes
  • Changes in ability to balance
  • Changes in normal walking
  • Changes to the coloration, volume and/or odor of any vaginal discharge
  • Clumsiness
  • Confusion about the time, place or person
  • Decrease in vision
  • Difficulty in moving
  • Discharge from the eye
  • Excessive tearing
  • Eye pain
  • Hallucinations
  • Holding of false beliefs and refusal to be dissuaded by fact.
  • Increase in hair growth that most commonly occurs on the face
  • Itching of the skin
  • Lack or loss of strength
  • Loss in sexual ability and desire
  • Loss of sexual drive and performance
  • Lost voice
  • Muscle jerking
  • Muscle stiffness
  • Muscle twitching
  • Night sweats
  • Pain in the breasts
  • Pain of the eyelid or inner eyelid
  • Pins and needles
  • Prickling of the skin
  • Rash
  • Redness, pain or swelling of the eye
  • Sleeplessness
  • Stomach discomfort
  • Swelling of the joints
  • Tearing
  • Uncontrolled rhythmic movements of muscles
  • Unsteadiness
  • Unusual excitement
  • Unusual nervousness
  • Unusual restlessness

Frequency of Incidence not known:

  • Decreased in interest in sexual intercourse
  • Diarrhea
  • Hives
  • Welts
  • Inability to get an erection
  • Inability to keep an erection
  • Indigestion
  • Reddening of the skin
  • Stomach upset

Other side effects from the use of Paricalcitol could also occur that have not been listed herein. If you experience any other side effects from use then you should inform your doctor or nurse and seek advice. If you are concerned about your immediate health, however, then you should always contact the emergency services.

Dosage

This medication will be administered by a trained professional. It will only ever be given to you in a hospital or dialysis center and should only be given under direct supervision of a doctor. The medication is injected directly into the vein of the patient.

When taking this medication you will also be given a special diet that you will need to follow. You should follow this exactly and you should not take any other type of nutritional aid or supplement without first discussing this with your doctor.

You may need to limit your intake of phosphate which is present in a lot of foods. Some examples include beer, chocolate, cheese, cola, fizzy drinks, ice cream, milk, peas, nuts, whole grain and yogurts.

Interactions

Certain medications should never be used in conjunction with one another. This is because they can interact with each other in the body and can cause significant medical complications. Before beginning treatment you must inform your doctor of all other treatments you are taking. For Paricalcitol it is especially important that you inform the doctor of all supplements and dietary aids that you take. These often contain calcium and phosphorous which can negate the effect of the treatment.

The use of the following medication with Paricalcitol will increase the risk of certain side effects occurring. Both treatments may be prescribed together, but the dose and frequency of use may need to be adjusted:

  • Ketoconazole

Certain foods, drinks and alcohol and tobacco products can interact with Paricalcitol. You will likely need to avoid foodstuffs containing phosphorous and calcium, including but not limited to the following:

  • Yogurts
  • Whole grain
  • Peas
  • Nuts
  • Milk
  • Ice cream
  • Fizzy drinks
  • Cola
  • Chocolate
  • Cheese
  • Beer

Other medical problems from which you suffer can also effect the use of this treatment. You must inform your doctor of all other medical conditions that you suffer from and any that you have suffered in the past. This is especially important in the following cases

These conditions may be worsened by treatment:

  • Bone disease
  • Heart rhythm problems
  • Hypercalciuria
  • Hyperphosphatemia

Patients with these conditions should not use Paricalcitol:

  • Hypercalcemia
  • Vitamin D overdose

Warnings

Before beginning use of Paricalcitol it is important that you understand the risks of use and ensure you have weighed them in relation to the potential benefits of use. Before you start treatment ensure that you have considered the following factors with your doctor:

Allergies You must inform your doctor of any allergies from which you suffer. Allergies may prohibit the use of this treatment. It is especially important to inform your doctor if you have ever reacted badly to any medications in the past.

Pediartic This medication has been tested in children aged 5+ and has been approved for safe and efficient use.

Geriatric There are no known limitations that could affect the use of this injection in the elderly.

Pregnancy You must inform your doctor if you are pregnant before you begin use. Use in pregnant women will pose a risk to the unborn baby and should be avoided wherever possible.

Breastfeeding The potential risks of breastfeeding while using this treatment are unknown. You should discuss the risks with your doctor and weigh them against the benefits of breastfeeding.

You will need to be regularly tested during your use of this treatment. Your doctor will need to ensure that it is working effectively and check for any unwanted side effects that may be occurring.

The amount of calcium in your blood may increase during use of this treatment. You should be alert to the symptoms of hypercalcemia and report them to your doctor immediately. These symptoms include:

  • Stomach or abdominal pains
  • Headaches
  • Incoherrance of speech
  • Metallic taste
  • Muscle weaknesses
  • Vomiting
  • Unusual tiredness
  • Weight loss
  • Nausea
  • Thirst

An increase in aluminium in the blood may occur with this treatment. Harm to the bones can result from use.

Do not take any other medications in conjunction with Paricalcitol unless they have been approved by your doctor.

Storage

Paricalcitol does not have special storage requirements. It has a shelf life of 2 years. Following opening it should be used immediately for treatment. Do not use it if its appearance has changed or if it is out of date.

Summary

Paricalcitol is an injected medication that is only given to patients in hospital or in a dialysis clinic. It is injected directly into the veins and should be given only by a trained medical professional.

This treatment is used to treat or prevent a condition called hyperthyroidism. This condition occurs when too much parathyroid hormone is produced and leads to an abundance of calcium and phosphorous in the blood.

Paricalcitol prevents the release of parathyroid hormone and in doing so helps to control the levels of these substances in the body.

Paricalcitol is used only in patients who are receiving dialysis for the treatment of chronic kidney disease.

A special diet is required alongside this treatment to further help in the control of calcium and phosphorous. It is very important that you follow the diet that is given to you by your doctor when being treated.

This medication can cause a range of different unwanted side effects to occur. You should ensure that you are fully aware of the risks of use before you begin treatment with Paricalcitol. If you have any questions about the medication then you should consult your doctor for advice.