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Cinacalcet Medication: Uses, Dosage, and Side Effects Overview
Summary of Key Points
Cinacalcet is a medication used to lower calcium levels in the blood, particularly for individuals with conditions such as hyperparathyroidism and chronic kidney disease. It works by regulating the activity of the parathyroid glands. Cinacalcet is commonly prescribed for patients with elevated calcium levels due to kidney problems or parathyroid tumors. Always consult your healthcare provider before starting or adjusting your dosage.
Names of Medication
US Brand Name: Sensipar
Generic Name: Cinacalcet
The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. The generic name (Cinacalcet) is listed in parentheses.
Pharmacologic Category
Calcimimetic
Cinacalcet belongs to a class of medications known as calcimimetics, which help lower calcium levels by increasing the sensitivity of the parathyroid glands to calcium in the blood.
Cinacalcet Dosage
Cinacalcet is prescribed for various conditions, and the dosage will depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. If needed, you can schedule a telemedicine appointment with one of our doctors.
Cinacalcet for Primary Hyperparathyroidism
Initial dose: 30 mg orally once daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 90 mg twice daily, depending on calcium levels.
Length of treatment: Long-term, depending on response and calcium levels.
Cinacalcet for Secondary Hyperparathyroidism (in patients with chronic kidney disease on dialysis)
Initial dose: 30 mg orally once daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 180 mg daily, depending on parathyroid hormone (PTH) levels.
Length of treatment: Long-term, based on PTH and calcium levels.
Cinacalcet for Tertiary Hyperparathyroidism
Initial dose: 30 mg orally once daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 90 mg twice daily, depending on calcium and PTH levels.
Length of treatment: Long-term, based on calcium and PTH levels.
Cinacalcet for Chronic Kidney Disease (CKD) with Hypercalcemia
Initial dose: 30 mg orally once daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 180 mg daily, depending on calcium levels.
Length of treatment: Long-term, depending on calcium levels.
Cinacalcet for Parathyroid Carcinoma
Initial dose: 30 mg orally twice daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 90 mg four times daily, depending on calcium levels.
Length of treatment: Long-term, based on calcium levels.
Hypercalcemia in Patients with Parathyroid Carcinoma or Primary Hyperparathyroidism Unable to Undergo Surgery
Initial dose: 30 mg orally twice daily.
Maintenance dose: The dose may be increased every 2 to 4 weeks to a maximum of 90 mg four times daily, depending on calcium levels.
Length of treatment: Long-term, based on calcium levels.
Dosage Forms and Strengths
Tablets: 30 mg, 60 mg, 90 mg
Administration Instructions for Cinacalcet
Cinacalcet should be taken with food or shortly after a meal to reduce the risk of stomach upset. Swallow the tablet whole; do not crush, chew, or split it. If you miss a dose, take it as soon as you remember, but skip it if it’s almost time for your next dose. Do not take two doses at once. Always follow your healthcare provider’s instructions for use.
Cinacalcet Side Effects and Adverse Reactions
Like all medications, Cinacalcet can cause side effects. Some are more common, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers to discuss your symptoms.
Common Side Effects (affecting more than 10% of patients)
Nausea: Feeling sick to your stomach, which may improve over time.
Vomiting: Throwing up, which may occur along with nausea.
Less Common Side Effects (affecting 1-10% of patients)
Diarrhea: Loose or watery stools.
Dizziness: Feeling lightheaded or unsteady.
Muscle pain: Soreness or discomfort in your muscles.
Rare but Serious Side Effects (affecting less than 1% of patients)
Low calcium levels (hypocalcemia): Symptoms include muscle cramps, tingling in the fingers or toes, and seizures. This requires immediate medical attention.
Allergic reactions: Symptoms include rash, itching, swelling, and difficulty breathing. Seek emergency medical care if you experience these symptoms.
Contraindications for Cinacalcet
A contraindication is a specific situation or condition where a medication should not be used because it may cause harm or worsen the patient’s condition. It’s important to know if you have any contraindications before starting a new medication.
Contraindications for Taking Cinacalcet
Hypocalcemia (Low Calcium Levels):Cinacalcet lowers calcium levels in the blood. If you already have low calcium levels, taking this medication can worsen the condition, potentially leading to serious complications like muscle spasms, seizures, or heart rhythm problems.
Allergic Reaction to Cinacalcet: If you have ever had an allergic reaction to Cinacalcet or any of its ingredients, you should not take this medication. Allergic reactions can range from mild rashes to severe, life-threatening conditions like anaphylaxis.
Severe Liver Disease: Patients with severe liver disease may have difficulty processing Cinacalcet, leading to higher levels of the drug in the body and an increased risk of side effects. Your healthcare provider may need to adjust your dose or recommend an alternative treatment.
If you have any of these conditions or concerns, it’s important to discuss them with your healthcare provider before starting Cinacalcet. You can schedule a telemedicine appointment with one of our providers to review your medical history and determine if Cinacalcet is right for you.
Drug to Drug Interactions with Cinacalcet
Some medications can interact with Cinacalcet, either increasing the risk of side effects or reducing its effectiveness. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements.
Medications That Interact with Cinacalcet
Ketoconazole (Nizoral): This antifungal medication can raise Cinacalcet levels in your blood, increasing the likelihood of side effects.
Itraconazole (Sporanox): Another antifungal that can similarly elevate Cinacalcet levels in the body.
Ritonavir (Norvir): This antiviral, commonly used to treat HIV, can increase Cinacalcet concentrations in the blood, potentially leading to toxicity.
Carbamazepine (Tegretol): This seizure medication can reduce Cinacalcet’s effectiveness by lowering its levels in the bloodstream.
Phenytoin (Dilantin): Another anti-seizure drug that can decrease Cinacalcet’s effectiveness.
Calcium Supplements: Taking calcium supplements while on Cinacalcet may counteract the medication’s effects, as Cinacalcet is designed to lower calcium levels.
Always consult your healthcare provider before starting or stopping any medications while taking Cinacalcet. Our telemedicine providers are available to help you review your medications and avoid harmful interactions.
Cinacalcet in Pregnancy
Is it Safe to Take Cinacalcet During Pregnancy?
There is limited data on the safety of Cinacalcet during pregnancy. While animal studies have shown some risk to the fetus, there is not enough information to determine the risk in humans. If you are pregnant or planning to become pregnant, it’s essential to discuss the potential risks and benefits of continuing Cinacalcet with your healthcare provider. They may recommend alternative treatments based on your specific condition.
Cinacalcet While Breastfeeding
Is it Safe to Take Cinacalcet While Breastfeeding?
It is unknown whether Cinacalcet passes into breast milk. Due to the potential risk to the nursing infant, it is generally advised to avoid breastfeeding while taking Cinacalcet. If you are breastfeeding or planning to breastfeed, talk to your healthcare provider about your options. They can help you weigh the risks and benefits and determine the best course of action for both you and your baby.
Estimated Cost of Cinacalcet Medication
The cost of a 30-day supply of Cinacalcet without insurance can vary. Using a GoodRx coupon, the estimated cost for a 30-day supply of Cinacalcet (30 tablets of 30 mg) ranges from approximately $300 to $400. Prices may differ depending on the pharmacy and location. Be sure to check GoodRx or other discount programs to find the best price available to you.
Possible Alternatives to Cinacalcet
Cinacalcet is used to treat several conditions, including hyperparathyroidism and hypercalcemia. Depending on your specific condition, there may be alternative treatments or lifestyle changes that could help. Always discuss these options with your healthcare provider before making any changes to your treatment plan. Our telemedicine providers can assist you in exploring alternatives and finding the best treatment for your needs.
Primary Hyperparathyroidism
Surgery: Surgical removal of the overactive parathyroid gland(s) may be recommended in some cases.
Vitamin D Supplementation: Correcting vitamin D deficiency may help manage calcium levels.
Secondary Hyperparathyroidism
Phosphate Binders: These medications help control phosphorus levels, which may reduce parathyroid hormone levels.
Vitamin D Analogues: Medications like calcitriol help manage calcium and phosphorus balance in patients with kidney disease.
Tertiary Hyperparathyroidism
Surgery: Parathyroidectomy may be considered in severe cases where medication is ineffective.
Chronic Kidney Disease
Dietary Changes: Reducing phosphorus intake can help manage complications related to hyperparathyroidism.
Dialysis: For patients with advanced kidney disease, dialysis may help manage calcium and phosphorus levels.
Hypercalcemia
Bisphosphonates: These medications help lower calcium levels in the blood.
Hydration: Increasing fluid intake can help flush excess calcium from the body.
Osteitis Fibrosa Cystica
Parathyroidectomy: Surgery to remove the overactive parathyroid glands may be necessary to prevent bone damage.
Parathyroid Carcinoma
Surgery: Removal of the cancerous parathyroid gland is often the first-line treatment.
Radiation Therapy: This may be used when surgery is not possible or to prevent recurrence.
Paget’s Disease of Bone
Bisphosphonates: These medications help slow bone turnover and reduce symptoms.
Calcitonin: This hormone helps regulate bone metabolism and reduce pain.
Bone Metastases
Radiation Therapy: This can help control pain and prevent further bone damage.
Bisphosphonates: These medications help strengthen bones and reduce the risk of fractures.
Hyperparathyroid Crisis
Intravenous Fluids: Hydration is often the first step in managing a hyperparathyroid crisis.
Calcitonin: This medication can help lower calcium levels quickly in emergency situations.
Recent Updates on Cinacalcet Research
Recent studies have explored the long-term effects of Cinacalcet on patients with chronic kidney disease and secondary hyperparathyroidism. Research suggests that Cinacalcet may help reduce the risk of cardiovascular events in these patients by lowering calcium and parathyroid hormone levels. However, more research is needed to confirm these findings and determine optimal dosing strategies.
Additionally, ongoing studies are investigating the use of Cinacalcet in patients with primary hyperparathyroidism who are not candidates for surgery. Early results suggest that Cinacalcet may be an effective alternative for managing calcium levels in these patients, but further research is required to establish its long-term safety and efficacy.
As new research emerges, it’s important to stay informed about your treatment options. Our telemedicine providers are available to discuss the latest findings and help you make informed decisions about your care.
