Paricalcitol

Paricalcitol

Clinical data
Trade names	Zemplar
AHFS/Drugs.com	Monograph
MedlinePlus	a682335
Pregnancy category	AU: C US: C (Risk not ruled out)
Routes of administration	Oral, Intravenous
ATC code	H05BX02 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) CA: ℞-only UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	72%
Protein binding	99.8%
Metabolism	Hepatic
Biological half-life	14-20 hours
Excretion	Faeces (74%), urine (16%)
Identifiers
IUPAC name (1R,3R,7E,17β)-17-[(1R,2E,4S)-5-hydroxy-1,4,5-trimethylhex-2-en-1-yl]-9,10-secoestra-5,7-diene-1,3-diol
Synonyms	(1R,3S)-5-[2-[(1R,3aR,7aS)-1-[(2R,5S)-6-hydroxy-5,6-dimethyl-3E-hepten-2-yl]-7a-methyl-2,3,3a,5,6,7-hexahydro-1H-inden-4-ylidene]ethylidene]-cyclohexane-1,3-diol
CAS Number	131918-61-1 Y
PubChem CID	5281104
IUPHAR/BPS	2791
DrugBank	DB00910 N
ChemSpider	4444552 Y
UNII	6702D36OG5
KEGG	D00930 N
ChEBI	CHEBI:7931 N
ChEMBL	CHEMBL1200622 Y
ECHA InfoCard	100.184.862
Chemical and physical data
Formula	C27H44O3
Molar mass	416.636 g/mol
InChI InChI=1S/C27H44O3/c1-18(8-9-19(2)26(3,4)30)24-12-13-25-21(7-6-14-27(24,25)5)11-10-20-15-22(28)17-23(29)16-20/h8-11,18-19,22-25,28-30H,6-7,12-17H2,1-5H3/b9-8+,21-11+/t18-,19+,22-,23-,24-,25+,27-/m1/s1 Y Key:BPKAHTKRCLCHEA-UBFJEZKGSA-N Y
NY (what is this?)

Paricalcitol (chemically it is 19-nor-1,25-(OH)₂-vitamin D₂. 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 renal failure. It is an analog of 1,25-dihydroxyergocalciferol, the active form of vitamin D₂ (ergocalciferol).

Its primary use in medicine is in the treatment of secondary hyperparathyroidism associated with chronic kidney disease. In three placebo-controlled studies, chronic renal failure patients treated with paricalcitol achieved a mean parathyroid hormone (PTH) reduction of 30% in six weeks. Additionally there was no difference in incidence of hypercalcemia or hyperphosphatemia when compared to placebo. A double-blind randomised study with 263 dialysis patients showed a significant advantage over calcitriol (also known as activated vitamin D₃; a similar molecule to 1,25-dihydroxyergocalciferol, adding a methyl group on C₂₄ and lacking a double-bond in the C₂₂ position). After 18 weeks, all patients in the paricalcitol group had reached the target parathormone level of 100 to 300 pg/ml, versus none in the calcitriol group. Combination therapy with paricalcitol and trandolapril has been found to reduce fibrosis in obstructive uropathy. Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in 227 patients with chronic kidney disease.

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. ^† These are adverse effects only seen in patients with grade 5 chronic kidney disease.

Contraindications include:

whereas cautions include: