Drug General Information (ID: DDIPRYOA5B)
Drug Name			Cinacalcet		Drug Info		Etelcalcetide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Calcimimetics				Calcimimetics
Structure

Mechanism of Cinacalcet-Etelcalcetide Interaction (Severity Level: Major)
Increased risk of hypocalcemia Click to Show/Hide Mechanism Graph
Drug Name		Cinacalcet				Etelcalcetide
Mechanism		Hypocalcemia				Hypocalcemia
Key Mechanism Factor 1
		Factor Name		Hypocalcemia
		Factor Description		Hypocalcemia is a low level of calcium found in a blood test. It can cause symptoms such as tingling, muscle cramps and heart rhythm problems that can range from mild to life-threatening.
Mechanism Description		Increased risk of hypocalcemia by the combination of Cinacalcet and Etelcalcetide

Recommended Action
Management		Concomitant use of etelcalcetide and cinacalcet is not recommended. At least 7 days should elapse when switching from cinacalcet to etelcalcetide, and the corrected serum calcium level should be at or above the lower limit of the normal range. In addition, the corrected serum calcium level should be measured within one week of initiation or dose adjustment of either etelcalcetide or cinacalcet and monitored approximately every 4 weeks. The manufacturer product labeling should be consulted for management guidelines in the event of a reduction in corrected serum calcium levels below the lower limit of the normal range and/or symptoms hypocalcemia. Patients should also be advised to contact their health care professional if they experience symptoms of hypocalcemia, such as numbness or tingling in the fingers, toes, or around the mouth, muscle spasms, twitches or cramps, seizures, confusion, and irregular heartbeats.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".