When This Medicine Should Not Be Used:
You should not receive this medicine if you have had an allergic reaction to paricalcitol, or if you have high levels of calcium or vitamin D in your blood.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• Carefully follow your doctor's instructions about any special diet and use of vitamin or mineral supplements.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using digoxin (Lanoxin®) or nefazodone (Serzone®). Tell your doctor if you are using a diuretic or "water pill" (such as hydrochlorothiazide [HCTZ]), medicine to treat an infection (such as clarithromycin, telithromycin, Biaxin®, or Ketek®), medicine to treat a fungal infection (such as itraconazole, ketoconazole, voriconazole, Nizoral®, Sporanox®, or Vfend®), or medicine to treat HIV or AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Norvir®, Reyataz®, or Viracept®).
• Do not use antacids or phosphate binders containing aluminum or supplements containing vitamin D, phosphate, or calcium without asking your doctor.
• Your doctor may tell you to limit your dietary intake of phosphate. Foods that are high in phosphate include beans, beer, chocolate, cheese, cola soft drinks, ice cream, milk, nuts, peas, whole grain products, and yogurt.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have bone disease or heart rhythm problems.
• This medicine may increase the calcium in your blood (hypercalcemia). The symptoms of high calcium may include abdominal or stomach pain; confusion; constipation; depression; dry mouth; headache; incoherent speech; increased urination; loss of appetite; metallic taste; muscle weakness; nausea; thirst; unusual tiredness; vomiting; or weight loss. If you have any of these symptoms, check with your doctor immediately.
• This medicine may increase the aluminum in your blood and may cause harm to your bones if used together with products containing aluminum (eg, antacids or phosphate binders). Ask your doctor before you take any of these medicines.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate.
• Chest pain, or fast, pounding, or uneven heartbeat.
• Cough, shortness of breath, or troubled breathing.
• Fever, chills, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Severe muscle pain or bone pain.
• Sudden and severe stomach pain.
• Sudden weight loss or loss of appetite.
• Swelling in your hands, ankles, or feet.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, constipation, nausea or vomiting, or upset stomach.
• Dryness or metallic taste in your mouth.
• Eye redness or sensitivity to light.
• Mild muscle, joint, or back pain.
• Mild skin rash or itching.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088