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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

Interactions with high risk of serious adverse effects and should be avoided:

• Burosumab

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Ketoconazole
• Vitamin D supplements (such as ergocalciferol)
• Products containing aluminum (such as certain antacids, phosphate binders)
• Corticosteroids (such as prednisone)

Interactions with low risk that usually do not require a change in therapy:

• Bile acid sequestrants (such as cholestyramine or colestipol)
• Mineral oil
• Orlistat