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This safety information outlines crucial warnings and contraindications associated with the use of this medication. Please read carefully and consult your healthcare provider if you have any questions or concerns.

• High Calcium Levels: Excessive intake of vitamin D can elevate calcium levels in the blood, potentially causing severe heart rhythm changes, seizures, and an increased risk of digitalis toxicity if you are taking digoxin (Lanoxin). The risk is heightened with high doses of calcium-containing medications, certain diuretics like hydrochlorothiazide (Microzide), or other vitamin D medications. Avoid prescription-strength vitamin D while on paricalcitol (Zemplar). Be aware of symptoms such as fatigue, confusion, decreased appetite, nausea, vomiting, constipation, increased thirst and urination, and weight loss. Report these to your provider immediately as they may necessitate emergency care. Your healthcare provider will monitor your calcium levels periodically.

• High Aluminum Levels: Utilizing paricalcitol (Zemplar) alongside medications with aluminum, such as antacids and phosphate binders, can result in harmful aluminum accumulation, leading to bone and muscle pain, fractures, and bone softening. Confirm with your provider or pharmacist if your medications contain aluminum.

Contraindications:

• Avoid the use of this medication if you have:
  • Elevated calcium levels.
  • High vitamin D levels, which may result in symptoms like nausea, vomiting, weakness, and frequent urination.

For any of these conditions, seek guidance from your healthcare provider before beginning this medication.

Common side effects:

• nausea
• diarrhea
• common cold symptoms
• vomiting
• high blood pressure
• swelling
• dizziness
• runny nose
• infections
• low blood pressure
• chills
• trouble sleeping
• vertigo
• headache
• rash

• increased fluid levels in the blood

  Less common but important to monitor:

• bleeding in the stomach
• stomach infections
• constipation
• increased urge to urinate
• flu-like symptoms
• arthritis or joint pain
• weakness
• pink eye
• asthma
• lung infections such as pneumonia

• fever

  Serious side effects:

• allergic reactions characterized by rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, and trouble breathing
• high calcium levels symptoms such as tiredness, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss

When taking this medication, be aware of potential interactions with certain drugs and supplements. Inform your doctor and pharmacist about all the medications and supplements you are using, whether they are prescribed or over-the-counter, including vitamins and herbal products.

This medication should not be used with burosumab, as it might affect treatment decisions. Additionally, if you are using Ketoconazole, there may be an increased risk of side effects. Your doctor might adjust the dosage or frequency of one or both medications if they are prescribed together.

Other products that may interact with this medication include vitamin D supplements (like Ergocalciferol) and products containing aluminum, such as certain antacids and phosphate binders. Corticosteroids like Prednisone may also interact. Be sure to check the labels of all your medications and supplements, as they may contain aluminum, Calcium, phosphate, or vitamin D. Consult your pharmacist on how to safely use these products.

Some medications, like bile acid sequestrants (such as Cholestyramine or Colestipol), Mineral Oil, and Orlistat, can reduce the absorption of vitamin D. It is advisable to separate your doses of these medications and vitamin D as much as possible. Taking vitamin D at bedtime might be a practical option. Discuss with your healthcare provider to determine the best dosing schedule for all your medications.

Finally, this medication might interfere with certain laboratory tests, potentially leading to false results. Ensure that all laboratory personnel and your healthcare providers are aware that you are using this medication.