Paricalcitol
Paricalcitol (chemically it is 19-nor-1,25-(OH)-vitamin D. Marketed by Abbott Laboratories under the trade name Zemplar) is a drug used for the prevention and treatment of secondary hyperparathyroidism (excessive secretion of parathyroid hormone) associated with chronic kidney failure. It is an analog of 1,25-dihydroxyergocalciferol, the active form of vitamin D (ergocalciferol). It was patented in 1989 and approved for medical use in 1998. Medical uses. Its primary use in medicine is in the treatment of secondary hyperparathyroidism associated with chronic kidney disease. However current evidence is not sufficient to demonstrate an advantage of paricalcitol over non-selective vitamin  D derivatives for this indication. Adverse effects. Adverse effects by frequency: Very common (>10% frequency): Common (1-10% frequency): Uncommon (0.1-1% frequency): These are adverse effects only seen in patients with grade 3 or 4 chronic kidney disease. Contraindications. Contraindications include: whereas cautions include: Interactions. Drugs that may interact with paricalcitol include: Overdose. Electrolyte abnormalities (e.g. hypercalcaemia and hyperphosphataemia) are common overdose symptoms. Treatment is mostly supportive, with particular attention being paid to correcting electrolyte anomalies and reducing intake of calcium in both the form of supplementation and diet. As it is so heavily bound to plasma proteins  haemodialysis is unlikely to be helpful in cases of overdose. Early symptoms of overdose can include: It is worth noting, however, that may of these symptoms are also indicative of kidney failure and hence may be masked by the patient's condition. Late symptoms of overdose include: Mechanism of action. Like 1,25-dihydroxyergocalciferol, paricalcitol acts as an agonist at the vitamin D receptor and thereby lowers parathyroid hormone levels in the blood. Pharmacokinetics. The plasma concentration of paricalcitol decreases rapidly and log-linearly within two hours after initial intravenous administration. Therefore, it is not expected to accumulate with multiple dosing , since paricalcitol is usually given no more frequently than every other day (3 times per week).