Zemplar has been evaluated for safety in clinical studies in 609 CKD Stage 5 patients. In four, placebo-controlled, double-blind, multicenter studies, discontinuation of therapy due to any adverse event occurred in 6.5% of 62 patients treated with Zemplar (dosage titrated as tolerated, see CLINICAL PHARMACOLOGY - Clinical Studies) and 2.0% of 51 patients treated with placebo for 1 to 3 months. Adverse events occurring in the Zemplar group at a frequency of 2% or greater and with an incidence greater than that in the placebo group, regardless of causality, are presented in the following table:
Adverse Event Incidence Rates for All Treated Patients In All Placebo-Controlled Studies
Adverse Event | Zemplar (n = 62) % | Placebo (n = 51) % |
Overall | 71 | 78 |
Cardiac Disorders | ||
Palpitations | 3.2 | 0.0 |
Gastrointestinal Disorders | ||
Dry Mouth | 3.2 | 2.0 |
Gastrointestinal Hemorrhage | 4.8 | 2.0 |
Nausea | 12.9 | 7.8 |
Vomiting | 8.1 | 5.9 |
General Disorders and Administration Site Conditions | ||
Chills | 4.8 | 2.0 |
Edema | 6.5 | 0.0 |
Malaise | 3.2 | 0.0 |
Pyrexia | 4.8 | 2.0 |
Infections and Infestations | ||
Influenza | 4.8 | 3.9 |
Pneumonia | 4.8 | 0.0 |
Sepsis | 4.8 | 2.0 |
Musculoskeletal and Connective Tissue Disorders | ||
Arthralgia | 4.8 | 3.9 |
A patient who reported the same medical term more than once was counted only once for that medical term.
Safety parameters (changes in mean Ca, P, Ca × P) in an open-label safety study up to 13 months in duration support the long-term safety of Zemplar in this patient population (see Clinical Studies).
Other Adverse Reactions Observed During Clinical Evaluation of Zemplar Injection (paricalcitol injection fliptop vial)
The following adverse reactions, with a causal relationship to Zemplar, occurred in < 2% of the Zemplar treated patients in the above double-blind, placebo-controlled clinical trial data set. In addition, the following also includes adverse reactions reported in Zemplar-treated patients who participated in other studies (non placebo-controlled), including double-blind, active-controlled and open-label studies:
Blood and Lymphatic System Disorders
Anemia, lymphadenopathy
Cardiac Disorders
Arrhythmia, atrial flutter, cardiac arrest
Ear and Labyrinth Disorders
Ear discomfort
Endocrine Disorders
Hyperparathyroidism, hypoparathyroidism
Eye Disorders
Conjunctivitis, glaucoma, ocular hyperemia
Gastrointestinal Disorders
Abdominal discomfort, constipation, diarrhea, dysphagia, gastritis, intestinal ischemia, rectal hemorrhage
General Disorders and Administration Site Conditions
Asthenia, chest discomfort, chest pain, condition aggravated, edema peripheral, fatigue, feeling abnormal, gait disturbance, injection site extravasation, injection site pain, pain, swelling, thirst
Infections and Infestations
Nasopharyngitis, upper respiratory tract infection, vaginal infection
Investigations
Aspartate aminotransferase increased, bleeding time prolonged, heart rate irregular, laboratory test abnormal, weight decreased
Metabolism and Nutrition Disorders
Decreased appetite, hypercalcemia, hyperkalemia, hyperphosphatemia, hypocalcemia
Musculoskeletal and Connective Tissue Disorders
Joint stiffness, muscle twitching, myalgia Neoplasms Benign,
Malignant and Unspecified
Breast cancer
Nervous System Disorders
Cerebrovascular accident, dizziness, dysgeusia, headache, hypoesthesia, myoclonus, paresthesia, syncope, unresponsive to stimuli
Psychiatric Disorders
Agitation, confusional state, delirium, insomnia, nervousness, restlessness
Reproductive System and Breast Disorders
Breast pain, erectile dysfunction
Respiratory, Thoracic and Mediastinal Disorders
Cough, dyspnea, orthopnea, pulmonary edema, wheezing
Skin and Subcutaneous Tissue Disorders
Alopecia, blister, hirsutism, night sweats, rash pruritic, pruritus, skin burning sensation
Vascular Disorders
Hypertension, hypotension
Additional Adverse Events Reported During Post-marketing Experience
Allergic reactions, such as rash, urticaria, and angioedema (including laryngeal edema) have been reported.