Paricalcitol
Paricalcitol is a synthetic vitamin D analog used to prevent and treat secondary hyperparathyroidism in patients with chronic kidney disease. It works by binding to vitamin D receptors and selectively activating vitamin D response pathways, which helps regulate calcium and phosphorus metabolism while reducing parathyroid hormone levels.
A synthetic vitamin D analog that treats secondary hyperparathyroidism in chronic kidney disease patients by selectively activating vitamin D receptors.
Key facts at a glance
- ATC
- H05BX02
- RxNorm
- 73710
- Generic
- Paricalcitol
- Class
- atc-h05
- Brands
- Zemplar
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- injection, capsule, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 1-2 mcg three times weekly
- Maximum
- consult physician
- Frequency
- non-consecutive days
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 0.04-0.1 mcg/kg three times weekly
- Maximum
- consult physician
- Frequency
- non-consecutive days
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 1-2 mcg three times weekly
- Maximum
- consult physician
- Frequency
- non-consecutive days
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
first trimesteravoid if possible
use only if potential benefits outweigh potential risks to fetus; avoid in first trimester unless absolutely necessary
regular fetal monitoring and ultrasound assessments
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
continue only if benefits outweigh risks; monitor maternal calcium levels closely
fetal monitoring, maternal calcium and phosphorus levels
Use with caution and monitor for adverse effects.
lactation
breastfeedingdiscontinue or avoid
it is unknown whether paricalcitol is excreted in human milk; due to potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug
monitor infant for hypercalcemia symptoms if mother continues breastfeeding while on medication
geriatric
elderlyno specific adjustment
use with caution; start at lower end of dosing range; monitor renal function and calcium levels
regular monitoring of serum calcium, phosphorus, and PTH levels; assess renal function
Use with caution and monitor for adverse effects.
pediatric_age
children adolescentsnot recommended
safety and efficacy have not been established in pediatric patients; use only if specifically prescribed by pediatric nephrologist
if used, monitor calcium, phosphorus, and PTH closely
renal_impairment
ESRD dialysisno adjustment needed
specifically indicated for secondary hyperparathyroidism in CKD patients on dialysis; monitor calcium and phosphorus levels regularly
frequent monitoring of serum calcium, phosphorus, and PTH levels; adjust dose based on PTH levels
renal_impairment
moderate to severeno adjustment needed
pharmacokinetics not significantly altered; monitor calcium and phosphorus levels
regular monitoring of serum calcium, phosphorus, and PTH
hepatic_impairment
mild moderateno specific adjustment
pharmacokinetics not significantly altered in mild to moderate hepatic impairment; use with caution
monitor calcium and phosphorus levels
Use with caution and monitor for adverse effects.
hepatic_impairment
severeuse with caution
pharmacokinetics not studied in severe hepatic impairment; use only if benefits outweigh risks
close monitoring of calcium, phosphorus, and liver function tests
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
Initial FDA approval for Paricalcitol (Zemplar)
Drug class
Pharmacological classification of Paricalcitol
Primary indication
Therapeutic use in CKD patients on dialysis
Mechanism of action
Pharmacodynamic properties
Prevention and treatment of secondary hyperparathyroidism associated with chronic kidney disease, particularly in patients undergoing dialysis.
As a vitamin D2 analog of calcitriol, paricalcitol binds to vitamin D receptors (VDR), selectively activating vitamin D response pathways to regulate calcium-phosphorus metabolism and suppress excessive parathyroid hormone secretion.
Requires regular monitoring of serum calcium, phosphorus, and PTH levels. Contraindicated in patients with hypercalcemia or vitamin D toxicity. Dosing must be individualized based on laboratory values, and patients should avoid phosphate binders and vitamin D supplements unless specifically directed by a healthcare provider.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy