paricalcitol at a glance
Medicine class
Selective vitamin D receptor activator and anti-parathyroid agent
Main role
Prevention and treatment of secondary hyperparathyroidism caused by chronic kidney disease
Available forms
Soft capsules and an intravenous solution given through haemodialysis access
Food
Capsules can be taken with or without food
Monitoring
Blood tests check parathyroid hormone, calcium and phosphate
What is paricalcitol used for?
The selected products are licensed for secondary hyperparathyroidism associated with chronic kidney disease.
Capsules: prevention and treatment in adults and children aged 10 to 16 years with chronic kidney disease stages 3 or 4.
Capsules: prevention and treatment in adults with stage 5 chronic kidney disease receiving haemodialysis or peritoneal dialysis.
Injection: prevention and treatment in adults with stage 5 chronic kidney disease undergoing haemodialysis.
How does paricalcitol work?
Damaged kidneys make less active vitamin D, contributing to excess parathyroid hormone production. Paricalcitol activates vitamin D receptors and calcium-sensing receptors in the parathyroid glands, reducing hormone production and release. It can still raise calcium and phosphate, so monitoring is important.
paricalcitol preparations and strengths
Capsule
Route: Oral
Strengths: 1 micrograms, 2 micrograms
Injection
Route: Parenteral
Strengths: 5 micrograms/mL
How to take paricalcitol
Use paricalcitol exactly as directed by the renal team; the prescription is adjusted using blood-test results.
Capsules may be taken with or without food.
The injection is administered by healthcare professionals through haemodialysis access.
Do not add vitamin D, calcium, magnesium, aluminium-containing antacids or other supplements without checking with the renal team or pharmacist.
paricalcitol side effects
Common or expected effects
- Raised blood calcium or phosphate, usually detected through blood tests
- Excessive suppression of parathyroid hormone, particularly with the injection
- Headache, altered taste or itching with the injection
Get urgent medical advice
- Severe allergic reaction, including angioedema or swelling around the throat
- Marked hypercalcaemia, which may cause weakness, drowsiness, confusion, vomiting, constipation or abnormal heart rhythm
- Persistent oversuppression of parathyroid hormone, which can contribute to low-turnover bone disease
paricalcitol in pregnancy
Human pregnancy information is limited and animal studies identified reproductive toxicity. Capsules should be used only when clearly necessary; the injection is not recommended during pregnancy. Discuss pregnancy or plans to conceive promptly with the renal and maternity teams.
paricalcitol while breastfeeding
It is unknown whether paricalcitol enters human milk, and risk to a breastfed infant cannot be excluded. A specialist should balance the benefits of treatment and breastfeeding and agree whether either needs to pause or stop.
paricalcitol interactions
Tell the renal team about prescribed, non-prescription and complementary products; mineral-containing preparations are especially relevant.
Other vitamin D or phosphate-containing products
Combined use increases the risk of high calcium, phosphate and calcium–phosphate product.
Calcium supplements or calcium-based phosphate binders
High calcium intake can increase hypercalcaemia risk.
Common questions about paricalcitol
Answers are fully visible for fast scanning and source review.
Is paricalcitol a vitamin D supplement?
It is a synthetic form of active vitamin D that selectively activates vitamin D receptors. It is prescribed for secondary hyperparathyroidism rather than routine vitamin D supplementation.
Why are blood tests needed?
Tests measure PTH, calcium and phosphate so the renal team can assess response and detect hypercalcaemia, hyperphosphataemia or excessive PTH suppression.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.