PARSABIV 2.5 MG SOLUTION FOR INJECTION - patient leaflet, side effects, dosage

Patient leaflet - PARSABIV 2.5 MG SOLUTION FOR INJECTION

1. what parsabiv is and what it is used for

Parsabiv contains the active substance etelcalcetide, which reduces parathyroid hormone known as PTH.

Parsabiv is used to treat secondary hyperparathyroidism in patients with serious kidney disease who need haemodialysis to clear their blood of waste products.

In secondary hyperparathyroidism too much PTH is produced by the parathyroid glands (four small glands in the neck). “Secondary” means that the hyperparathyroidism is caused by another condition, e.g. kidney disease. Secondary hyperparathyroidism can cause the loss of calcium from the bones, which can lead to bone pain and fractures and problems with blood and heart vessels. By controlling the levels of PTH, Parsabiv helps to control calcium and phosphate in your body.

2. what you need to know before you use parsabiv

Do not use Parsabiv

– if you are allergic to etelcalcetide or any of the other ingredients of this medicine (listed in section 6).
– if you have very low levels of calcium in your blood. Your doctor will monitor your blood calcium levels.

Warnings and precautions

Before you are given Parsabiv, tell your doctor if you have or have ever had:

heart problems, such as heart failure or arrhythmias (abnormal heart rhythm);
seizures (fits or convulsions).

Parsabiv reduces calcium levels. Please tell your doctor if you have spasms, twitches, or cramps in your muscles, or numbness or tingling in your fingers, toes or around your mouth or seizures, confusion or loss of consciousness while being treated with Parsabiv. For additional information see section 4.

Low calcium levels can cause abnormal heart rhythm. Tell your doctor if you experience an unusually fast or pounding heartbeat, if you have heart rhythm problems or heart failure or if you take medicines that can cause heart rhythm problems, while receiving Parsabiv. For additional information see section 4.

Very low levels of PTH over long periods can result in a type of abnormal bone structure known as adynamic bone which can only be diagnosed by biopsy. Your PTH levels will be monitored during treatment with Parsabiv and your dose of Parsabiv may be reduced if your PTH levels become very low.

Children and adolescents

It is not known whether Parsabiv is safe and effective in children less than 18 years of age as it has not been studied in these patients.

Other medicines and Parsabiv

Tell your doctor if you are taking, have recently taken or might take any other medicines, including those medicines obtained without a prescription, or any other medicines that lower serum calcium (e.g. cinacalcet and denosumab).

You should not receive Parsabiv together with cinacalcet. Tell your doctor if you are taking cinacalcet or have recently taken cinacalcet.

Pregnancy

Parsabiv has not been tested in pregnant women. It is not known whether Parsabiv can harm your unborn baby. Tell your doctor if you are pregnant, think you may be pregnant, or plan to get pregnant when taking Parsabiv. As a precautionary measure, it is preferable to avoid the use of Parsabiv during pregnancy.

Breast-feeding

It is not known whether Parsabiv can pass into breast milk. Tell your doctor if you are breast-feeding or plan to do so. Your doctor will then help you decide whether to stop breast-feeding, or whether to stop taking Parsabiv, considering the benefit of breast-feeding to the baby and the benefit of Parsabiv to the mother.

Driving and using machines

Parsabiv has no or negligible influence on the ability to drive and use machines. However certain symptoms of low calcium levels (such as fits or convulsions) can affect your ability to drive or operate machinery.

Parsabiv contains sodium

This medicine contains less than 1 mmol sodium (23 mg) per vial, that is to say essentially ‘sodium-free’.

3. how to use parsabiv

The recommended starting dose for Parsabiv is 5 mg. It will be given by a doctor or nurse at the end of your haemodialysis treatment through the tube (bloodline) that connects you to the haemodialysis machine. Parsabiv will be given 3 times per week. The dose may be increased up to 15 mg or lowered down to 2.5 mg depending on your response.

You may need to take calcium and vitamin D supplements while being treated with Parsabiv. Your doctor will discuss this with you.

If you have any further questions on the use of this medicine, ask your doctor or nurse.

4. possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Low calcium levels in blood (hypocalcaemia) have been reported commonly (may affect up to 1 in 10 people). If you feel numbness or tingling around your mouth or in your extremities, muscle aches or cramps and seizures (fits), you should tell your doctor immediately. These may be signs that your calcium levels are too low.

Very common: may affect more than 1 in 10 people

Nausea
Vomiting
Diarrhoea
Muscle spasms
Low calcium levels in blood with no symptoms

Common: may affect up to 1 in 10 people

High potassium levels in blood
Low phosphate levels in blood
Headache
Numbness or tingling sensation
Worsening heart failure
Disturbances in the heart’s electrical activity seen as QT prolongation on electrocardiogram
Low blood pressure
Muscle pain

Uncommon: may affect up to 1 in 100 people

Seizures (fits or convulsions); for additional information see section 2

Not known: frequency cannot be estimated from the available data

Allergic reactions (including anaphylactic reactions)

Reporting of side effects

If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine.

Yellow Card Scheme

Website: or search for MHRA Yellow Card in the Google Play or Apple App Store

5. how to store parsabiv

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

Store in a refrigerator (2°C – 8°C).

Keep the vial in the outer carton in order to protect from light.

Once removed from the refrigerator:

Parsabiv is stable for a maximum of 7 cumulative days if stored in the original carton. No special temperature storage requirements are needed.
If removed from the original carton Parsabiv is stable for a maximum of 4 hours if protected from direct sunlight.

Do not use this medicine if you notice it has particles or it has changed colour.

For single use only.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. contents of the pack and other information

What Parsabiv contains

– The active substance is etelcalcetide.

Parsabiv 2.5 mg solution for injection: Each vial contains 2.5 mg of etelcalcetide in

0.5 mL solution (5 mg/mL).

Parsabiv 5 mg solution for injection: Each vial contains 5 mg of etelcalcetide in

1 mL solution (5 mg/mL).

Parsabiv 10 mg solution for injection: Each vial contains 10 mg of etelcalcetide in

2 mL solution (5 mg/mL).

– The other ingredients are sodium chloride, succinic acid, water for injections, hydrochloric acid, and sodium hydroxide (refer to section 2: Parsabiv contains sodium).

What Parsabiv looks like and contents of the pack

Parsabiv is a clear and colourless liquid.

Parsabiv is a solution for injection in a vial.

Pack sizes of 1,6, 12 and 42 vials.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Amgen Limited

216 Cambridge Science Park

Milton Road

Cambridge

CB4 0WA

United Kingdom

Manufacturer

Amgen Europe B.V.

Minervum 7061

4817 ZK Breda

The Netherlands

For any information about this medicine, please contact the local representative of the

Marketing Authorisation Holder: