Drug Index


Mechanism :

Synthetic vitamin D analog, reduces parathyroid hormone (PTH).

Indication :

  • Secondary Hyperparathyroidism: Prevention and treatment in pediatric patients 10 years and older with secondary hyperparathyroidism associated with stage 3 and 4 CKD and stage 5 CKD patients on hemodialysis or peritoneal dialysis

Contraindications :

Hypersensitivity to paricalcitol or any component of the formulation; vitamin D toxicity; hypercalcemia.

Dosing :

Use in children ≥5 years of age.
0.04 to 0.1 mcg/kg IV (2.8 to 7 mcg) alternate day during dialysis; dose may be increased by 2 to 4 mcg every 2 to 4 weeks.
Dose Monitoring based on iPTH levels:
Same or increasing iPTH level or iPTH level decreased by <30%: Increase paricalcitol dose
iPTH level decreased by >30% and <60%: Maintain paricalcitol dose.
iPTH level decrease by >60%: Decrease paricalcitol dose.
Oral: Use between 10-16 years.
Initial dose (Mcg) = baseline iPTH level/120 given 3 times/week. Every 4 weeks may increase dose by 1 mcg to maintain iPTH within target range.

Adverse Effect :

Nausea, diarrhea, infection, rhinitis, hyper/hypotension, edema, palpitations, syncope, dizziness, chills, insomnia, vertigo, anxiety, depression, skin rash, dermal ulcer, ecchymoses, hypovolemia, dehydrations, hypoglycaemia, GIT haemorrhage, peritonitis, abdominal pain, urinary urgency, chronic renal failure, anemia, lymphadenopathy, hypersensitivity reactions.

Interaction :

Bile Acid Sequestrants: May decrease the serum concentration of Vitamin D Analogs.
Digoxin: Paricalcitol may enhance the adverse/toxic effect of Digoxin.
Orlistat: May decrease the serum concentration of Paricalcitol.
Sucralfate: Vitamin D Analogs may increase the serum concentration of Sucralfate.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

Mild to moderate hepatic impairment: no dose adjustment required,
Severe hepatic impairment: Safety profile has not been evaluated and dosing has not been studied but caution should be taken.
03/21/2024 01:02:34 Paricalcitol
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