Dosing changes should occur in 2 to 4 mcg increments. If hypercalcemia develops, the dose should be decreased or the injection held until the serum calcium levels are within normal range. If the dose is held, it should be decreased prior to restarting the regimen. In addition, patients need to be reminded to adhere to the phosphorus restriction in the diet and to maintain the calcium supplement throughout therapy. Patients should not be receiving phosphate or other vitamin D related compounds while taking paricalcitrol.
Cyclooxygenase is responsible for converting arachidonic acid into prostaglandins.
Normal expression of prostaglandins occurs in tissues, gastrointestinal tract and renal tubules and are formed from the conversion of arachidonic acid by the enzyme cyclooxygenase. Pharmacokinetic parameters for Celecoxib and Rofecoxib are compared in Table 2. The most commonly cited adverse effects noted with both agents in clinical trials include headache, diarrhea, nausea, dyspepsia and abdominal pain. These drugs are not recommended for use in patients who have severe hepatic damage, history of gastrointestinal bleeds, or ulcers. Celecoxib and rofecoxib are contraindicated in patients with a history of allergic reactions to the drug or the product ingredients.