Zemplar
- Generic Name: paricalcitol tablets
- Brand Name: Zemplar
- Drug Class: Vitamin D Analogs
Zemplar (Paricalcitol Tablets) side effects drug center
Zemplar Side Effects Center
What Is Zemplar Injection?
Zemplar (paricalcitol) Injection is a form of vitamin D indicated for the prevention and treatment of secondary hyperparathyroidism associated with chronic kidney disease Stage 5.
What Are Side Effects of Zemplar Injection?
Common side effects of Zemplar Injection include:
- nausea
- vomiting
- gastrointestinal bleeding
- chills
- fever
- influenza
- pneumonia
- severe infection (sepsis)
- joint pain
- palpitations
- dry mouth
- swelling, and
- feeling unwell
Dosage for Zemplar Injection
The recommended initial dose of Zemplar is 0.04 mcg/kg to 0.1 mcg/kg (2.8 – 7 mcg) administered as a bolus dose no more frequently than every other day at any time during dialysis.
What Drugs, Substances, or Supplements Interact with Zemplar Injection?
Zemplar Injection may interact with azole antifungals, antiviral medications, macrolide antibiotics, nefazodone, and digitalis. Tell your doctor all medications and supplements you use.
Zemplar Injection During Pregnancy or Breastfeeding
During pregnancy, Zemplar should be used only if prescribed. It is unknown if Zemplar passes into breast milk. Breastfeeding while taking Zemplar is not recommended.
Additional Information
Our Zemplar (paricalcitol) Injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
Zemplar Consumer Information
SIDE EFFECTS: Headache, nausea, chills, or fever may occur. If any of these effects persist or worsen, tell your doctor promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication may raise your vitamin D and calcium levels too high. Tell your doctor immediately if any of these unlikely but serious effects of too much vitamin D/calcium occur: constipation, drowsiness, dry mouth, muscle/bone/joint pain, metallic taste in mouth, weakness, vomiting.
Tell your doctor immediately if any of these rare but serious side effects of very high vitamin D levels occur: loss of appetite, unusual weight loss, eye pain/redness/sensitivity to light, severe runny nose, stomach/abdominal pain.
Tell your doctor right away if you have any serious side effects, including: dizziness, fast/irregular/pounding heartbeat, swelling hands/ankles/feet, severe mental/mood changes (e.g., agitation, confusion), easy bleeding/bruising, bloody/tarry stool, vomit that looks like coffee grounds.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Zemplar (Paricalcitol Tablets)
Zemplar Professional Information
SIDE EFFECTS
The following serious adverse reactions are described below and elsewhere in the labeling:
- Hypercalcemia [see WARNINGS AND PRECAUTIONS]
- Adynamic Bone Disease [see WARNINGS AND PRECAUTIONS]
Clinical Trials Experience
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.
Four placebo-controlled, double-blind, multicenter studies were conducted in 113 patients (51% male, 10% Caucasian, 81% African-American and 9% Hispanic, ranging in age from 18 to 90 years). Sixty-two patients were exposed to ZEMPLAR and the average dose at the end of treatment was 0.12 mcg/kg/dose with a mean number of 55 days of dosing across the studies. Discontinuation of therapy due to any adverse reaction occurred in 6.5% of patients treated with ZEMPLAR and 2.0% of patients treated with placebo. Adverse reactions occurring with greater frequency in the ZEMPLAR group and at a frequency of 2% or greater are presented in Table 3.
Table 3: Adverse Reactions Occurring at a Rate of 2% or Greater in Patients with CKD on Dialysis in Four Placebo-Controlled Studies
Adverse Reaction | Placebo (n = 51) % |
ZEMPLAR (n = 62) % |
Nausea | 8 | 13 |
Vomiting | 6 | 8 |
Edema | 0 | 7 |
Gastrointestinal Hemorrhage | 2 | 5 |
Chills | 2 | 5 |
Pyrexia | 2 | 5 |
Pneumonia | 0 | 5 |
Sepsis | 2 | 5 |
Influenza | 4 | 5 |
Arthralgia | 4 | 5 |
Palpitations | 0 | 3 |
Dry Mouth | 2 | 3 |
Malaise | 0 | 3 |
Other Adverse Reactions
The following adverse reactions occurred in less than 2% of the ZEMPLAR treated patients in the above mentioned studies and in additional double-blind, active-controlled and open-label studies:
Blood and Lymphatic System Disorders: Anemia, lymphadenopathy
Cardiac Disorders: Arrhythmia, atrial flutter, irregular heart rate, cardiac arrest, chest discomfort, chest pain, edema peripheral
Ear and Labyrinth Disorders: Ear discomfort
Endocrine Disorders: Hypoparathyroidism
Eye Disorders: Conjunctivitis, glaucoma, ocular hyperemia
Gastrointestinal Disorders: Abdominal discomfort, constipation, diarrhea, dysphagia, gastritis, intestinal ischemia, rectal hemorrhage
General Disorders: Asthenia, condition aggravated, fatigue, feeling abnormal, pain, swelling Infections: Nasopharyngitis, upper respiratory tract infection, vaginal infection
Injection site reactions: Injection site extravasation, injection site pain
Laboratory abnormalities: Hypercalcemia, hyperkalemia, hyperphosphatemia, hypocalcemia, increased aspartate aminotransferase, prolonged bleeding time
Metabolism and Nutrition Disorders: Decreased appetite, thirst, decreased weight
Musculoskeletal and Connective Tissue Disorders: Joint stiffness, muscle twitching, myalgia
Neoplasms Benign, Malignant and Unspecified: Breast cancer
Nervous System Disorders: Cerebrovascular accident, dizziness, dysgeusia, headache, hypoesthesia, myoclonus, paresthesia, syncope, unresponsive to stimuli, gait disturbance
Psychiatric Disorders: Agitation, confusional state, delirium, insomnia, nervousness, restlessness
Reproductive System and Breast Disorders: Breast pain, erectile dysfunction
Respiratory, Thoracic and Mediastinal Disorders: Cough, dyspnea, orthopnea, pulmonary edema, wheezing
Skin and Subcutaneous Tissue Disorders: Alopecia, blister, hirsutism, night sweats, rash pruritic, pruritus, skin burning sensation
Vascular Disorders: Hypertension, hypotension
Postmarketing Experience
The following adverse reactions have been identified during post-approval use of ZEMPLAR. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Allergic reactions, such as rash, urticaria, and angioedema (including laryngeal edema) have been reported.
DRUG INTERACTIONS
Table 4 includes clinically significant drug interactions with ZEMPLAR.
Table 4: Clinically Significant Drug Interactions with ZEMPLAR
Drugs that May Increase the risk of Hypercalcemia | |
Clinical Impact | Concomitant administration of high doses of calcium-containing preparations or other vitamin D compounds may increase the risk of hypercalcemia. Thiazide diuretics are known to induce hypercalcemia by reducing excretion of calcium in the urine. |
Examples | Calcium-containing products, other vitamin D compounds or thiazide diuretics |
Intervention | Monitor calcium more frequently and adjust ZEMPLAR dose as needed [see WARNINGS AND PRECAUTIONS]. |
Digitalis Compounds | |
Clinical Impact | ZEMPLAR can cause hypercalcemia which can potentiate the risk of digitalis toxicity. |
Intervention | Monitor patients for signs and symptoms of digitalis toxicity and increase frequency of serum calcium monitoring when initiating or adjusting the dose of ZEMPLAR in patients receiving digitalis compounds [see WARNINGS AND PRECAUTIONS]. |
Strong CYP3A Inhibitors | |
Clinical Impact | ZEMPLAR is partially metabolized by CYP3A. Exposure of ZEMPLAR will increase upon coadministration with strong CYP3A inhibitors [see CLINICAL PHARMACOLOGY]. |
Examples | Boceprevir, clarithromycin, conivaptan, grapefruit juice, indinavir, itraconazole, ketoconazole, lopinavir/ritonavir, mibefradil, nefazodone, nelfinavir, posaconazole, ritonavir, saquinavir, telithromycin, and voriconazole |
Intervention | If a patient initiates or discontinues therapy with a strong CYP3A4 inhibitor, dose adjustment of ZEMPLAR may be necessary. Monitor intact PTH and serum calcium concentrations closely. |
Read the entire FDA prescribing information for Zemplar (Paricalcitol Tablets)
&Copy; Zemplar Patient Information is supplied by Cerner Multum, Inc. and Zemplar Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.