Understanding the Generic Name: What is another name for Zemplar?
Zemplar is the brand name for the medication whose generic name is paricalcitol. This synthetic version of vitamin D is prescribed for patients with chronic kidney disease (CKD) who develop secondary hyperparathyroidism (SHPT). By providing a manufactured analog of active vitamin D, paricalcitol helps the body regulate the overproduction of parathyroid hormone (PTH) that often accompanies kidney failure. Both brand-name and generic versions are available.
How Paricalcitol Works
Paricalcitol binds to vitamin D receptors (VDR) in various tissues, including the parathyroid glands, suppressing PTH synthesis and secretion.
- Receptor Activation: Paricalcitol activates the VDR, regulating genes for PTH synthesis.
- Hormone Suppression: Suppressing PTH secretion helps restore calcium and phosphorus balance.
- Mineral Regulation: In CKD, the kidneys struggle to activate vitamin D. Paricalcitol provides the necessary active component for calcium homeostasis, bypassing impaired kidney function.
Approved Indications for Zemplar (Paricalcitol)
Zemplar is indicated for the prevention and treatment of secondary hyperparathyroidism (SHPT).
- CKD Stages 3 and 4: Approved for adults and children 10+ to manage SHPT.
- Patients on Dialysis: Used for adults and children 5+ on hemodialysis or peritoneal dialysis for Stage 5 CKD (ESRD) to control SHPT.
Comparison of Vitamin D Analogs
Zemplar (paricalcitol) is one of several vitamin D analogs for SHPT.
| Feature | Paricalcitol (Zemplar) | Calcitriol (Rocaltrol) | Doxercalciferol (Hectorol) |
|---|---|---|---|
| Mechanism | Synthetic vitamin D2 analog, selective VDR activation | Active form of vitamin D3, non-selective VDR activation | Synthetic vitamin D2 analog, converted to active form in liver |
| Risks | Lower risk of high calcium levels compared to calcitriol | Higher risk of hypercalcemia and elevated calcium-phosphorus product | Risk of hypercalcemia; often requires more careful monitoring |
| Dosing | Oral capsules: 1-8 mcg/day or 3x/week. IV injection: 3x/week | Oral capsules: Daily dosing. IV injection: 3x/week | Oral capsules: Once per day or 3x/week. IV injection: 3x/week |
| Cost | Available in a more affordable generic form | Available in a more affordable generic form | Available in a more affordable generic form |
| Pediatric Use | Approved for children as young as 5 years for injection; 10 years for oral capsules | Can be used in young children | Approved for adults only |
Important Safety and Usage Information
Side Effects and Monitoring
Patients should be aware of potential side effects and the need for regular monitoring of calcium, phosphorus, and PTH levels.
Common side effects include nausea, vomiting, diarrhea, swelling, and dizziness. Serious side effects like hypercalcemia (dangerously high calcium) require immediate medical attention for symptoms like increased thirst, urination, confusion, or weakness.
Drug Interactions and Precautions
Inform your healthcare provider about all medications, supplements, and vitamins. Interactions include:
- CYP3A4 Inhibitors: Medications like ketoconazole can increase paricalcitol levels.
- Aluminum-Containing Products: Antacids with aluminum can lead to aluminum toxicity.
- Calcium and Vitamin D Supplements: Additional supplements without supervision can cause dangerously high calcium levels.
Dietary Considerations
A special diet, often with restricted phosphorus intake from foods like dairy, nuts, and whole grains, may be necessary. A healthcare provider or dietitian can provide guidance.
Conclusion
Zemplar is the brand name for paricalcitol, a synthetic vitamin D analog treating secondary hyperparathyroidism in CKD patients. It suppresses PTH and regulates mineral balance with a lower hypercalcemia risk than calcitriol. Adherence to medication, diet, and monitoring is crucial. Both generic and brand-name formulations require medical supervision. More detailed information can be found in the official FDA label for Zemplar.
