Cinacalcet (Oral)

Cinacalcet is used in patients who suffer from chronic kidney disease and use dialysis, as well as suffering from hyperparathyroidism.

Overview

Cinacalcet is used for the treatment of hyperparathyroidism in patients who also suffer from chronic kidney disease that require their use of dialysis.

Hyperparathyroidism is a condition whereby the parathyroid glands make too great a quantity of the parathyroid hormone (PTH). In normal bodily function this hormone is used in the control of concentrations of phosphorous and calcium in the blood. When there is too much PTH present in the blood the levels of calcium and phosphorous will increase too.

Cinacalcet is used in order to lower the volume of PTH in the blood and in doing so this lowers the phosphorous and calcium concentrations in the blood.

Patients suffering from parathyroid cancer and primary hyperparathyroidism can also be treated for high levels of calcium in the blood using Cinacalcet. This treatment works in the same way by reducing calcium levels through the inhibition of the parathyroid gland.

This medication is available with a doctor's prescription only. The medication is delivered in the form of a Sensipar tablet.

Condition treated

  • Hyperparathyroidism

Type of medicine

  • Parathyroid hormone (PTH) inhibitor

Side Effects

In addition to the desired effects of the use of this treatment, this medication can also cause some unwanted effects in the patient. Some of these side effects will abate over time, whereas others will require the patient to seek medical attention.

You should seek medical attention immediately that you experience any of the following side effects:
Occurring more commonly:

  • Blurring of the vision
  • Changed heartbeat
  • Chest pains
  • Dizziness
  • Headaches
  • Nervousness
  • Pounding sensation in the ears

Occurring less commonly:

  • Convulsions or seizures
  • Coughing or hoarseness
  • Feverishness or chills when warm
  • Loss ability to control bladder
  • Lower back pain or side pain
  • Muscle spasming or uncontrollable jerking of all extremities
  • Pain or difficulty experienced during urination
  • Sudden loss of level of consciousness

Occurrence unknown:

  • Abdominal cramping
  • Confusion or disorientation
  • Decreased volume of urine output
  • Difficulty in breathing
  • Difficulty in moving
  • Dizziness or feeling of faintness rising suddenly from lying or sitting down
  • Extreme fatigue
  • Fainting or faintness
  • Irregular breathing
  • Irregular heartbeats
  • Joint pains
  • Large swellings with the appearance of hives appearing on the

o Eyelids
o Face
o Feet
o Hands
o Legs
o Lips
o Sex organs
o Throat
o Tongue

  • Low bone turnover
  • Mood changes or difference in mental state
  • Muscle aching or cramps
  • Muscle pains
  • Muscle stiffness
  • Numb or tingling sensations around mouth, fingertips, or feet
  • Stomach cramps
  • Sweating when cool
  • Swollen face, fingers, feet, or lower legs
  • Swollen joints
  • Tightness experienced across the chest
  • Tremor
  • Troubled breathing
  • Unusual tiredness
  • Visibly dilated neck veins
  • Unusual weakness
  • Weight increase

Other side effects can occur that would not usually require you to seek medical attention. If you experience any of the following side effects then they will usually abate over time. If they become bothersome or are ongoing then inform your healthcare professional:

  • Diarrhea
  • Hives
  • Itchiness
  • Lack of strength
  • Loss of appetite
  • Loss of strength
  • Nausea
  • Rash
  • Reddening of the skin
  • Vomiting
  • Weight loss
  • Welts

Other side effects that are not listed herein may also be experienced. If you experience other side effects then inform your doctor and seek advice.

Dosage

This medication should be taken only as instructed. Do not to more than prescribed, take it more frequently than prescribed or continue use once the period of prescription has ended.

This medication should be taken shortly after eating a meal.

The tablets should be swallowed whole and should not be crushed, dissolved, broken or chewed.

The dose of this medication will differ for each patient. The following information is for guidance only and you should not make any changes to the dose that you take unless instructed to by your doctor.

  • For the treatment of hypercalcemia in patients with parathyroid cancer or hyperparathyroidism:
    Adults: 30mg twice daily. Dose may be adjusted every 2-4 weeks upon examination at a regular appointment.
  • Children: Use to be determined by the doctor.

For the treatment of hyperparathyroidism for patients suffering from chronic kidney disease:

  • Adults:30mg once daily. Dose may be adjusted every 2-4 weeks upon examination at a regular appointment.
  • Children:Use to be determined by the doctor.

If you miss a dose then you should take it as soon as possible unless you are close to your next scheduled dose. If you are close to your next scheduled dose then you should skip the missed dose and return to your usual schedule of treatment. Never take a double dose of this medication.

Interactions

Medications can interact with one another in the body. In some cases they can cause severe side effects when used in conjunction with one another. In other cases medications can counteract each other's effects and they can also increase the risk of occurrence or severity of certain side effects that may occur. You should inform your doctor of all medications that you are taking before you begin use of this treatment. This includes over the counter treatments, other prescribed treatments, herbal remedies, vitamin supplements and any other substances that you take.

The use of the following medications in addition to Cinacalcet is not recommended. If you are taking these medications then your doctor may change one or more prescription.

  • Nebivolol
  • Fluoxetine
  • Eliglustat
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Donepezil
  • Clozapine
  • Brexpiprazole

The following medications would not normally be recommended for use in patients who are also using Cinacalcet as they will increase the risk or certain side effects when used in conjunction with one another. In some cases a doctor may prescribe both, but may adjust the dose or frequency of one or more prescriptions:

  • Desipramine
  • Ketoconazole

Further interactions with other medications may occur. This list has been selected for severity but is not all-inclusive. It is vital that you inform your doctor of all medications that you take before you begin treatment.

Other medical problems can also impact the use of this treatment. Patients who suffer from other medical conditions should inform their doctor of all other conditions before beginning treatment. This is particularly important in patients who suffer from the following conditions:
These conditions may be worsened by use of this treatment:

  • Bone disease
  • Heart disease
  • Heart failure
  • Heart rhythm problems
  • Hypotension
  • History of seizures

Side effects may be increased in patients who suffer from the following condition:
'Liver disease

Other interactions with medical conditions not listed herein may also occur. Ensure that you tell your doctor of all conditions from which you suffer.

Warnings

Before deciding to begin treatment with this medication you should consider the risks against the good that it may do. You should make this decision with your doctor having considered the following factors:

Allergies: Inform your doctor of any unusual reactions you have ever had to any medications. You should also inform them of any allergies from which you suffer including allergies to dyes, foods, animals, preservatives and other substances.

Pediatric: Safety and efficiency of use in children has not been determined. Discuss use with your doctor.

Geriatric: Appropriate studies have not shown any specific problems that should limit the use in the elderly. Beware of an increased chance or liver disease, kidney disease and heart disease that may limit effective use.

Pregnancy: A risk to the fetus in pregnant women has been demonstrated. Inform your doctor if you are pregnant or may get pregnant during use of this treatment. When using this treatment you should ensure that you are following effective contraceptive practices and you should inform your doctor straight away if you believe you have become pregnant during use.

Breastfeeding: The potential risks of breastfeeding with this medication are unknown. You should discuss nursing an infant with your doctor before beginning use.

You will need to make regular visits to your doctor to check the effectiveness of the treatment when taking this medication. Blood tests may be required.

This medication can lower the calcium levels in your blood. This can cause serious problems and you should inform your doctor immediately if you get any of the following symptoms:

  • Abdominal cramps
  • Confusion or disorientation
  • Convulsions or seizures
  • Difficulty in breathing
  • Irregular heartbeats
  • Mental differences
  • Mood changes
  • Muscle cramping
  • Numbness of the face or mouth
  • Stomach cramps
  • Tremors

Inform your doctor right away if you notice a change in your heart rhythm. This is particularly important if anyone in your family has ever suffered from heart problems. You should inform your doctor of this before starting the medication.

Do not take any other medications in addition to this treatment unless you have discussed this with your doctor. This includes over the counter medications, prescribed medications and herbal remedies too.

Storage

The medication should be stored in a closed and sealed container. Store it at room temperature away from moisture, heat and light. Prevent from freezing.

  • Always keep medications out of the reach of children.
  • Do not keep outdated medications for longer than they are needed.
  • Check with your healthcare professional for information on how best to dispose of medication.

Summary

Cinacalcet is used for the treatment of patients suffering from hyperparathyroidism in cases of chronic kidney disease that requires the use of dialysis.

This condition causes the parathyroid glad to produce parathyroid hormone it greater quantities than required. The increase of this hormone in the blood causes the body to absorb more calcium and phosphorous into the blood, which can then cause significant medical problems. In normal bodily functions this hormone controls the levels of these substances, but with hyperparathyroidism this control is lost.

Cinacalcet can be used to lower the volume of the hormone in the blood by inhibiting its production. In turn the treatment will lower the phosphorous and calcium concentrations in the blood.

There is a risk in the use of this treatment that the calcium levels in the blood will become too low and expose the patient to other health risks. Patients should learn the symptoms of low calcium levels before use in order to be able to recognise them and react appropriately.

Patients suffering from parathyroid cancer and primary hyperparathyroidism can also be treated for high levels of calcium in the blood using Cinacalcet.

This treatment can cause a wide range of side effects in patients. Before taking this medication you should weight the benefits of doing so against the potential risks of doing so.

There is a range of medical conditions that would prohibit the use of this treatment or make it inadvisable as a course of treatment. Ensure that your doctor is fully aware of the medication conditions from which you suffer before beginning treatment with this medication. Medical conditions that you have suffered from in the past and heart conditions that your blood relatives have suffered from can also be relevant.

Resources
Last Reviewed:
January 31, 2018
Last Updated:
April 12, 2018