Drug Interaction Report

MONITOR: Coadministration of denosumab with calcimimetic drugs such as cinacalcet and etelcalcetide, may increase the risk of hypocalcemia. This risk may be significantly higher in patients with severe renal dysfunction (creatinine clearance less than 30 mL/min) and in those receiving dialysis. The mechanism of this interaction is thought to be due to additive hypocalcemic effects.

MANAGEMENT: Caution and close monitoring of serum calcium concentrations are recommended when denosumab is used concomitantly with calcimimetic drugs such as cinacalcet and etelcalcetide. Patients and clinicians should be alert for signs and symptoms of hypocalcemia, such as numbness or tingling in the fingers, toes, or around the mouth, muscle spasms, twitches or cramps, seizures, mental status changes (confusion, irritability, depression), and irregular heartbeats.