Drug General Information (ID: DDIZBKNV6O)
Drug Name			Pamidronic acid		Drug Info		Etelcalcetide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinflammatory Agents				Calcimimetics
Structure

Mechanism of Pamidronic acid-Etelcalcetide Interaction (Severity Level: Major)
Increased risk of hypocalcemia Click to Show/Hide Mechanism Graph
Drug Name		Pamidronic acid				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 Pamidronic acid and Etelcalcetide

Recommended Action
Management		Close monitoring of corrected serum calcium levels is recommended if etelcalcetide is used in combination with other medications known to lower serum calcium, such as denosumab, calcitonin, foscarnet, bisphosphonates, or loop diuretics. It is recommended that the patient's corrected serum calcium level should be measured within one week of initiation or dose adjustment of etelcalcetide and monitored approximately every 4 weeks. In addition, 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 of 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.".
2	Product Information. Skelid (tilundronate). Sanofi Winthrop Pharmaceuticals, New York, NY.