Etelcalcetide Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Do NOT use cincalcet and etelcalcetide simultaneously. If switching from cinacalcet to etelcalcetide a 7-day washout is advised before starting the first dose of etelcalcetide.
  • Detailed dosage adjustment advice is provided in the manufacturer's SPC
  • Serum calcium levels quoted in the manufacturer's SPC are based on assays measured using Roche modular analysers only. CAUTION intepreting local laboratory serum calcium if other analysers deployed.

Available preparations

Parsabiv 2.5mg in 0.5mL

Parsabiv 5mg in 1mL

Reconstitution

Not required- already in solution

Infusion fluids

Not required

Methods of intravenous administration

  • Administer by bolus intravenous injection
  • It is administered into the venous line of the dialysis circuit at the end of haemodialysis treatment during the rinse-back, or intravenously after rinse-back
  • When given during rinse-back, at least 150mL of rinse-back volume should be administered after injection
  • If rinse-back is completed and the drug is being given, it may be administered intravenously followed by at least 10mL flush of Sodium chloride 0.9%

Dose in adults

Initial dose

  • Usually 5mg three times per week
  • Dose should be titrated: increase dose in 2.5 or 5mg increments no more frequently than every four weeks
  • Dose range 2.5 to 15mg per dose
  • Maximum dose: 15mg three times per week
  • Maximum frequency: three times per week
  • If doses are missed for more than two weeks, restart at 5mg dose (or 2.5mg if that was the patient's last administered dose) and titrate to achieve the desired PTH

Monitoring

  • Dose should be adjusted according to parathyroid hormone (PTH) levels - see SPC
  • PTH levels should be measured after four weeks from initiation or dose adjustment of etecalcetide and approximately every 1-3 months during maintenance
  • Serum calcium levels should be measured prior to initiating treatment, within 1 week of initiation or dose adjustment of etelcalcetide and every 4 weeks during treatment. If clinically meaningful decreases in corrected serum calcium levels occur, steps should be taken to increase serum calcium levels - dose modification may be required - see SPC

Storage

Store between 2 and 80C

References

Parsabiv SPC - downloaded from EMEA 12th Jan 2023

Therapeutic classification

Anti-parathyroid agent