Storing
Prepping
Administering
Not an actual Parsabiv® vial. The displayed vials are for illustrative purposes only.
A quick reference on how to use Parsabiv® (etelcalcetide)
To ensure the prescribed dose is withdrawn from the vial, keep it upright. DO NOT invert the vial.
Consider using a 1.5" needle for withdrawal of Parsabiv® to ensure that the needle reaches the bottom of the vial.
Insert the needle and tilt the vial approximately 45 degrees to withdraw all of the prescribed dose.
DO NOT mix or dilute Parsabiv® (etelcalcetide) prior to administration.1 The solution is clear and colorless. Inspect Parsabiv® for particulate matter and discoloration prior to administration. DO NOT use Parsabiv® vials if particulate matter or discoloration is observed.
Once Parsabiv® is withdrawn from the vial, administer immediately.
Not an actual Parsabiv® vial. The displayed vial is for illustrative purposes only.
A quick reference on how to use Parsabiv® (etelcalcetide)
Learn about dose sizes
and safe storage
Once Parsabiv® is removed from the refrigerator:
HOW
By intravenous bolus injection
WHERE
Into the venous line of the dialysis circuit
WHEN
Only at the end of hemodialysis, IV after rinse back or during rinse back
DO NOT:
DO NOT pull the venous needle/catheter after rinse back. Alert the nurse that it's time to administer Parsabiv®.
If giving IV after rinse back, flush with at least 10 mL of saline
ORIf giving during rinse back, flush with at least 150 mL of saline
Parsabiv® is removed by the dialyzer membrane and must be administered after blood is no longer circulating through the dialyzer.1
A quick reference on how to use Parsabiv® (etelcalcetide)
Learn about dose sizes
and safe storage
Contraindication: Parsabiv® (etelcalcetide) is contraindicated in patients with known hypersensitivity to etelcalcetide or any of its excipients. Hypersensitivity reactions, including face edema and anaphylactic reaction, have occurred.
Hypocalcemia: Parsabiv® lowers serum calcium and can lead to hypocalcemia, sometimes severe. Significant lowering of serum calcium can cause QT interval prolongation and ventricular arrhythmia. Patients with conditions that predispose to QT interval prolongation and ventricular arrhythmia may be at increased risk for QT interval prolongation and ventricular arrhythmias if they develop hypocalcemia due
Contraindication: Parsabiv® (etelcalcetide) is contraindicated in patients with known hypersensitivity to etelcalcetide or any of its excipients. Hypersensitivity reactions, including face edema and anaphylactic reaction, have occurred.
Hypocalcemia: Parsabiv® lowers serum calcium and can lead to hypocalcemia, sometimes severe. Significant lowering of serum calcium can cause QT interval prolongation and ventricular arrhythmia. Patients with conditions that predispose to QT interval prolongation and ventricular arrhythmia may be at increased risk for QT interval prolongation and ventricular arrhythmias if they develop hypocalcemia due to Parsabiv®. Closely monitor corrected serum calcium and QT interval in patients at risk on Parsabiv®.
Significant reductions in corrected serum calcium may lower the threshold for seizures. Patients with a history of seizure disorder may be at increased risk for seizures if they develop hypocalcemia due to Parsabiv®. Monitor corrected serum calcium in patients with seizure disorders on Parsabiv®.
Concurrent administration of Parsabiv® with another oral calcimimetic 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.
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®. Measure PTH 4 weeks after initiation or dose adjustment of Parsabiv®. Once the maintenance dose has been established, measure PTH per clinical practice.
Worsening Heart Failure: In Parsabiv® clinical studies, cases of hypotension, congestive heart failure, and decreased myocardial performance have been reported. Closely monitor patients treated with Parsabiv® for worsening signs and symptoms of heart failure.Upper Gastrointestinal Bleeding: In clinical studies, 2 patients treated with Parsabiv® in 1253 patient years of exposure had upper gastrointestinal (GI) bleeding at the time of death. The exact cause of GI bleeding in these patients is unknown and there were too few cases to determine whether these cases were related to Parsabiv®.
Patients with risk factors for upper GI bleeding, such as known gastritis, esophagitis, ulcers or severe vomiting, may be at increased risk for GI bleeding with Parsabiv®. Monitor patients for worsening of common Parsabiv® GI adverse reactions and for signs and symptoms of GI bleeding and ulcerations during Parsabiv® therapy.
Adynamic Bone: Adynamic bone may develop if PTH levels are chronically suppressed.
Adverse Reactions: In clinical trials of patients with secondary HPT comparing Parsabiv® to placebo, the most common adverse reactions were blood calcium decreased (64% vs. 10%), muscle spasms (12% vs. 7%), diarrhea (11% vs. 9%), nausea (11% vs. 6%), vomiting (9% vs. 5%), headache (8% vs. 6%), hypocalcemia (7% vs. 0.2%), and paresthesia (6% vs. 1%).
Parsabiv® (etelcalcetide) is indicated for the treatment of secondary hyperparathyroidism (HPT) in adult patients with chronic kidney disease (CKD) on hemodialysis.
Limitations of Use: Parsabiv® has not been studied in adult patients with parathyroid carcinoma, primary hyperparathyroidism, or with CKD who are not on hemodialysis and is not recommended for use in these populations.
Limitations of Use: Parsabiv® has not been studied in adult patients with parathyroid carcinoma, primary hyperparathyroidism, or with CKD who are not on hemodialysis and is not recommended for use in these populations.
Please see Parsabiv® (etelcalcetide) full Prescribing Information.
