Calcium Complexation: Many agents can induce hypocalcemia by causing complexes to form between the medication and serum calcium. This complexation of calcium is so rapid and massive that maximal PTH secretion is inadequate to compensate for the sudden drop in serum calcium. A classic example of this phenomenon is foscarnet, an antiviral agent often used in immunocompromised patients.
Acute infusion reactions during or within 1 to 2 hours of infusion are common with infliximab, and other TNF inhibitors, particularly with the first or second dose. Symptoms include fever, chills, pruritus, urticaria, dyspnoea, chest pain, and hypertension or hypotension.