• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

1. What Zemplar is and what it is used for
2. What you need to know before you take Zemplar
3. How to take Zemplar
4. Possible side effects
5. How to store Zemplar
6. Contents of the pack and other information

• if you are allergic to paricalcitol or any of the other ingredients of this medicine (listed in section 6).
• if you have very high levels of calcium or vitamin D in your blood.

Your doctor will be able to tell you if these conditions apply to you.

Talk to your doctor or pharmacist before taking Zemplar.

• before the treatment begins, it is important to limit the amount of phosphorus in your diet.
• phosphate-binding medicines may be needed to control phosphorus levels. If you are taking calcium-based phosphate binders, the doctor may need to adjust your dose.
• your doctor will need to do blood tests to monitor your treatment.
• in some patients with chronic kidney disease stages 3 and 4, an increase in the blood levels of a substance called creatinine has been observed. However, this increase does not reflect a reduction in renal function.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Some medicines may affect the action of this medicine or may increase the likelihood of side-effects. It is particularly important to tell your doctor if you are taking any of the following medicines:

• to treat fungal infections such as candida or thrush (for example ketoconazole)
• to treat heart problems or high blood pressure (for example digoxin, diuretics or water pills)
• that contain a source of phosphate (for example, medicines to lower calcium levels in the blood)
• that contain calcium or Vitamin D, including supplements and multivitamins that can be bought without a prescription
• that contain magnesium or aluminium (for example some types of indigestion medicines (antacids) and phosphate-binders)
• to treat elevated cholesterol levels (for example cholestyramine)

Zemplar may be taken with or without food.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

There is no adequate data on the use of paricalcitol in pregnant women. Potential risk in human use is not known, therefore paricalcitol should not be used unless clearly necessary.

It is not known if paricalcitol passes into human breast milk. Tell your doctor before breast-feeding while taking Zemplar.

Zemplar should not affect your ability to drive or use machines.

This medicine contains 0.71 mg of alcohol (ethanol) in each 1 microgram capsule and 1.42 mg of alcohol (ethanol) in each 2 micrograms capsule. The amount per capsule of this medicine is equivalent to less than 1 ml beer or wine.

The small amount of alcohol in this medicine will not have any noticeable effects.

In adult patients the usual initial dose is one capsule every day, or every other day, up to three times a week. Your doctor will use the results of your laboratory tests to decide the correct dose for you. Once Zemplar is started, the dose is likely to need adjusting, depending on how you respond to treatment.

Your doctor will help determine the correct dose of Zemplar for you.

Chronic Kidney Disease Stage 5

In adult patients the usual initial dose is one capsule every other day, up to three times a week. Your doctor will use the results of your laboratory tests to decide the correct dose for you. Once Zemplar is started, the dose is likely to need adjusting, depending on how you respond to treatment. Your doctor will help determine the correct dose of Zemplar for you.

If you have mild to moderate liver disease, your dose will not need to be adjusted. However, there is no experience in patients with severe liver disease.

The usual dose is one capsule every day, or every other day, up to three times a week. Your doctor will use the results of your laboratory tests to decide the correct dose for you. Once Zemplar is started, the dose is likely to need adjusting, depending on how you respond to treatment. Your doctor will help determine the correct dose of Zemplar for you.

In children ages 10 to 16 years of age with chronic kidney disease Stages 3 or 4 the usual initial dose is one capsule every other day, up to three times a week. Your doctor will use the results of your laboratory tests to decide the correct dose for you. Once Zemplar is started, the dose is likely to need adjusting, depending on how you respond to treatment. Your doctor will help determine the correct dose of Zemplar for you.

The efficacy of Zemplar in children with CKD Stage 5 has not been established.

There is no information on the use of Zemplar capsules in children under the age of 10 years.

There is a limited amount of experience of using Zemplar in patients aged 65 years or older. In general no overall differences in effectiveness or safety were seen between patients aged 65 years or older and younger patients.

Too much Zemplar can cause abnormally high levels of calcium in the blood, which can be harmful. Symptoms which can appear soon after taking too much Zemplar may include a feeling of weakness and/or drowsiness, headache, nausea (feeling sick) or vomiting (being sick), a dry mouth, constipation, pains in muscles or bones and a metallic taste in the mouth.

Symptoms which can develop over a longer period of taking too much Zemplar include loss of appetite, drowsiness, weight loss, sore eyes, a runny nose, itchy skin, feeling hot and feverish, loss of sex drive and severe abdominal pain (due to an inflamed pancreas) and kidney stones. Your blood pressure may be affected and heart beat irregularities (palpitations) can occur. The results of blood and urine tests may show high cholesterol, urea, nitrogen and raised levels of liver enzymes. Zemplar may rarely cause mental changes including confusion, drowsiness, insomnia or nervousness.

If you take too much Zemplar, or experience any of the above, seek medical advice immediately.

If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, do not take the dose that you have missed, simply continue to take Zemplar as previously directed (dose and time) by your doctor.

Do not take a double dose to make up for a forgotten dose.

Unless your doctor tells you to stop your treatment, it is important to keep taking Zemplar as your doctor has directed.

• allergic reactions (such as shortness of breath, wheezing, rash, itching, or swelling of the face and lips)

Tell your doctor or nurse if you notice any of the following side effects:

Common (may affect up to 1 in 10 people):

• increase in the blood levels of a substance called calcium, as well as the amount of calcium times the amount of another substance in the blood called phosphate (in patients with significant chronic kidney disease)
• phosphate blood levels also may be increased

Uncommon (may affect up to 1 in 100 people):

• pneumonia (lung infection)
• decreased levels of parathyroid hormone
• decreased appetite
• decreased levels of calcium
• dizziness
• unusual taste in the mouth
• headache
• irregular heartbeat
• stomach discomfort or pain
• constipation
• diarrhoea
• dry mouth
• heartburn (reflux or indigestion)
• nausea
• vomiting
• acne
• itchy skin
• rash
• hives
• muscle cramps
• muscle pain
• breast tenderness
• weakness
• feeling tired, not feeling well
• swelling in the legs
• pain
• increased levels of creatinine
• changes in liver function tests

If you experience an allergic reaction, please contact your doctor immediately.

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

By reporting side effects you can help provide more information on the safety of this medicine.

Zemplar 1 micrograms capsules

• The active substance is paricalcitol. Each soft capsule contains 1 microgram of paricalcitol.
• The other ingredients are: medium chain triglycerides, ethanol, butylhydroxytoluene.
• The capsule shell contains: gelatin, glycerol, water, titanium dioxide (E 171), iron oxide black (E 172).
• The printing ink contains: propylene glycol, black iron oxide (E172), polyvinyl acetate phthalate, Macrogol 400 ammonium hydroxide.

Zemplar 2 micrograms capsules

• The active substance is paricalcitol. Each soft capsule contains 2 micrograms of paricalcitol.
• The other ingredients are: medium chain triglycerides, ethanol, butylhydroxytoluene.
• The capsule shell contains: gelatin, glycerol, water, titanium dioxide (E 171), iron oxide red (E 172) and iron oxide yellow (E 172).
• The printing ink contains: propylene glycol, black iron oxide (E172), polyvinyl acetate phthalate, Macrogol 400, ammonium hydroxide

Zemplar 1 micrograms capsules

Zemplar 1 microgram capsules, is an oval, grey soft capsule imprinted with ZA.

Each carton contains either 1 or 4 foil blister packs. Each blister contains 7 capsules.

Zemplar 2 micrograms capsules

Zemplar 2 micrograms capsules, is an oval, orange-brown soft capsule imprinted with ZF.

Each carton contains either 1 or 4 foil blister packs. Each blister contains 7 capsules.

Marketing Authorisation Holder:

Manufacturer: