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Overview: Parsabiv is used to treat hyperparathyroidism in people with chronic kidney disease who are on dialysis. It is an intravenous (IV) injection that is given by a health care provider. Parsabiv works by causing your parathyroid gland to release less parathyroid hormone. Common side effects include muscle spasms, diarrhea, and nausea. Parsabiv may also cause low calcium levels, which can sometimes be severe. Call your health care provider right away if you have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Uses

What is Parsabiv used for?

Parsabiv (etelcalcetide) is commonly used to treat hyperparathyroidism in people who have chronic kidney disease (CKD) and are on dialysis. Hyperparathyroidism is a condition that results in high levels of parathyroid hormone.

Parsabiv may also be used for other conditions as determined by your health care provider.

How does Parsabiv work (mechanism of action)?

Parsabiv binds to the calcium-sensing receptor (CaSR) in your body. This makes the receptor respond better to calcium in your blood. This signals your parathyroid gland to release less parathyroid hormone, which helps lower parathyroid hormone levels in your blood.

How is Parsabiv supplied (dosage forms)?

Brands and other names

  • Parsabiv

Dosage forms and strengths

Parsabiv is available in an injectable form that is given by a health care provider.

How should I store Parsabiv?

Parsabiv is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Parsabiv?

The most common side effects of Parsabiv are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Low calcium levels (see below)
  • Muscle spasms
  • Diarrhea
  • Nausea or vomiting
  • Headache
  • Numbness, tingling, or burning in your arms, feet, or face

There may be other side effects of Parsabiv that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Parsabiv?

While less common, the most serious side effects of Parsabiv are described below, along with what to do if they happen.

Severe Allergic Reactions. Parsabiv may cause allergic reactions, which can be serious. Stop using Parsabiv and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Low Calcium Levels (Hypocalcemia). Parsabiv can cause low calcium levels, which can sometimes be severe. Low calcium levels can cause serious side effects, including a rare but dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people may be at higher risk of this, including those who have other people in their family who have had this condition. Stop using Parsabiv and call your health care provider right away if you have any of the following symptoms of low calcium levels.

  • Changes in your heart rate or rhythm, such as a fast or skipping heartbeat
  • Fainting
  • Numbness, tingling, or burning sensation in your arms, feet, or face (paresthesia)
  • Muscle pain or spasms
  • Seizures

Heart Failure. Parsabiv may worsen heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Upper Stomach Bleeding. Parsabiv can increase your risk of bleeding, ulcers, and tears (perforation) in your esophagus, stomach, or the first part of your small intestine. Stop using Parsabiv and get emergency help if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Warnings & Precautions

Who should not use Parsabiv?

Allergies to Ingredients. People who are allergic to any of the following should not use Parsabiv.

  • Etelcalcetide
  • Parsabiv
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Parsabiv.

What should I know about Parsabiv before using it?

Parsabiv is usually given after dialysis by a health care provider in a hospital or clinic. Your health care provider will give it by injection into your vein (IV).

Keep all appointments to have your blood work checked before starting and while you are using Parsabiv. This helps your health care provider make sure it is safe for you to keep using the medicine.

What should I tell my health care provider before using Parsabiv?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Parsabiv is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems, including heart rhythm problems, long QT syndrome, or heart failure
  • Family history of heart problems
  • Stomach problems, such as inflammation, ulcers, or bleeding
  • Esophagus problems
  • Severe vomiting
  • Seizures

Other Medicines and Supplements. Parsabiv may interact with other medicines and supplements. Before using Parsabiv, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Parsabiv could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if Parsabiv passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Parsabiv while breastfeeding.

How can I get more information about Parsabiv?

For more information about Parsabiv, you can visit the manufacturer’s website at www.parsabiv.com or call them at 800-772-6436.

Interactions

Does Parsabiv interact with foods or drinks?

There are no known interactions between Parsabiv and foods or drinks.

It is unknown if drinking alcohol will affect Parsabiv, but both Parsabiv and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does Parsabiv interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking any other medicine that may lower calcium levels, including the following.

  • Cinacalcet, which is a medicine used for high parathyroid hormone levels (hyperparathyroidism) and parathyroid cancer
  • Denosumab (Prolia, Xgeva, and others), which is a medicine used to treat osteoporosis or bone problems in certain people with cancer

This may not be a complete list of medicines that can interact with Parsabiv. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Parsabiv?

If you or someone else has used too much Parsabiv, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Parsabiv?

Parsabiv is usually given after dialysis by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving Parsabiv as scheduled. If you miss an appointment for dialysis, call to make another appointment as soon as possible.