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Drug Safety-related Labeling Changes (SrLC)

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PARSABIV (NDA-208325)

(ETELCALCETIDE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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03/08/2019 (SUPPL-2)

Approved Drug Label (PDF)

4 Contraindications

(additions underlined)

Hypersensitivity

PARSABIV is contraindicated in patients with known hypersensitivity to etelcalcetide or any of its excipients. Hypersensitivity reactions, including face edema  and anaphylactic reaction, have occurred with PARSABIV.

5 Warnings and Precautions

5.1 Hypocalcemia

(additions underlined)

Risk of Hypocalcemia with Other Serum Calcium Lowering Products

Concurrent administration of PARSABIV with another oral calcium-sensing receptor agonist could result in severe, life-threatening hypocalcemia. Patients switching from cinacalcet to PARSABIV should discontinue cinacalcet for at least 7 days prior to initiating PARSABIV.  Closely monitor corrected serum calcium in patients receiving PARSABIV and concomitant therapies known to lower serum calcium.

 

Monitoring Serum Calcium and Patient Education

Measure corrected serum calcium prior to initiation of PARSABIV. Do not initiate in patients if the corrected serum calcium is less than the lower limit of normal. Monitor corrected serum calcium within 1 week after initiation or dose adjustment and every 4 weeks during treatment with PARSABIV.  Educate patients on the symptoms of hypocalcemia and advise them to contact a healthcare provider if they occur.

 

Management of Hypocalcemia

If corrected serum calcium falls below the lower limit of normal or symptoms of hypocalcemia develop, start or increase calcium supplementation (including calcium, calcium-containing phosphate binders, and/or vitamin D sterols or increases in dialysate calcium concentration). PARSABIV dose reduction or discontinuation of PARSABIV may be necessary.

6 Adverse Reactions

6.3 Postmarketing Experience

(new subsection added)

The following adverse reactions have been identified during postmarketing use of PARSABIV.

Because postmarketing reporting of adverse reactions is voluntary and from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Anaphylactic reaction

  • Hypocalcemia in patients who were administered etelcalcetide concomitantly with other products known to lower serum calcium (e.g. cinacalcet, denosumab)

  • Seizures secondary to hypocalcemia