| Hyperparathyroidism, Secondary
Parsabiv vs Zemplar
Side-by-side clinical, coverage, and cost comparison for hyperparathyroidism, secondary.Deep comparison between: Parsabiv vs Zemplar with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsZemplar has a higher rate of injection site reactions vs Parsabiv based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zemplar but not Parsabiv, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Parsabiv
Zemplar
At A Glance
IV injection
Three times per week
Calcimimetic agent
Oral
Daily or three times weekly
Vitamin D analog
Indications
- Hyperparathyroidism, Secondary
- Hyperparathyroidism, Secondary
Dosing
Hyperparathyroidism, Secondary Starting dose 5 mg IV bolus three times per week at end of hemodialysis; maintenance dose individualized by titration, range 2.5 to 15 mg three times per week.
Hyperparathyroidism, Secondary (CKD Stages 3-4, Adults) Initial: 1 mcg orally daily or 2 mcg three times weekly if iPTH <=500 pg/mL; 2 mcg orally daily or 4 mcg three times weekly if iPTH >500 pg/mL. Titrate: Increase by 1 mcg daily or 2 mcg three times weekly if iPTH unchanged or changed <30%; maintain dose if iPTH decreased 30-60%; decrease by 1 mcg daily or 2 mcg three times weekly if iPTH decreased >60% or iPTH <60 pg/mL.
Hyperparathyroidism, Secondary (CKD Stage 5, Adults) Initial: Dose (mcg) = baseline iPTH (pg/mL) divided by 80, administered orally three times weekly (no more frequently than every other day). Ensure baseline serum calcium <=9.5 mg/dL. Titrate: Dose (mcg) = most recent iPTH (pg/mL) divided by 80; decrease by 2-4 mcg if serum calcium is elevated.
Hyperparathyroidism, Secondary (CKD Stages 3-4, Pediatric 10-16 years) Initial: 1 mcg orally three times weekly, no more frequently than every other day. Titrate: Increase each dose by 1 mcg three times weekly every 4 weeks or decrease by 1 mcg three times weekly at any time based on iPTH, serum calcium and phosphorus levels.
Hyperparathyroidism, Secondary (CKD Stage 5, Pediatric 10-16 years) Initial: Dose (mcg) = baseline iPTH (pg/mL) divided by 120 (round down), administered orally three times weekly, no more frequently than every other day. Titrate: Increase each dose by 1 mcg three times weekly every 4 weeks or decrease by 2 mcg three times weekly at any time based on iPTH, serum calcium and phosphorus levels.
Contraindications
- Known hypersensitivity to etelcalcetide or any of its excipients
- Hypercalcemia
- Vitamin D toxicity
Adverse Reactions
Most common (>=5%) Blood calcium decreased, muscle spasms, diarrhea, nausea, vomiting, headache, hypocalcemia, paresthesia
Serious Hypocalcemia, worsening heart failure, upper gastrointestinal bleeding, adynamic bone
Postmarketing Anaphylactic reaction, hypocalcemia with concomitant calcium-lowering agents, seizures secondary to hypocalcemia
Most common (>=5%) in CKD Stages 3-4 Vertigo (5%), diarrhea (7%), nausea (6%), vomiting (5%), edema (6%), hypersensitivity (6%), viral infection (7%), arthritis (5%), dizziness (5%), headache (5%), hypertension (7%), hypotension (5%)
Most common (>=5%) in CKD Stage 5 Diarrhea (11%), nasopharyngitis (8%), dizziness (7%), vomiting (7%), peritonitis (5%), fluid overload (5%), insomnia (5%), constipation (5%)
Postmarketing Angioedema (including laryngeal edema), blood creatinine increased
Pharmacology
Etelcalcetide is a calcimimetic agent that allosterically modulates the calcium-sensing receptor (CaSR), enhancing activation by extracellular calcium to decrease PTH secretion from parathyroid chief cells.
Paricalcitol is a synthetic vitamin D2 analog that binds to the vitamin D receptor (VDR), selectively activating vitamin D responsive pathways, inhibiting PTH synthesis and secretion, thereby reducing parathyroid hormone levels in secondary hyperparathyroidism.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Parsabiv
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Zemplar
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Parsabiv
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Zemplar
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Parsabiv
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Zemplar
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAmgen Safety Net Foundation
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Zemplar.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
ParsabivView full Parsabiv profile
ZemplarView full Zemplar profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.