Cinacalcet

Cinacalcet is a prescription medication used to treat high calcium levels in the body. Cinacalcet belongs to a group of drugs called calcimimetics, which work by signaling the body to produce less parathyroid hormone in order to decrease the amount of calcium in the blood.

It is available in tablet form and is taken by mouth with food. Do not chew, divide, or break cinacalcet tablets. Swallow tablets whole.

Common side effects include nausea, vomiting, and diarrhea.
.

Cinacalcet is a prescription medication used to regulate calcium levels in the following patients:

• those with secondary hyperparathyroidism and chronic kidney disease who are also on dialysis. Hyperthyroidism is when your body makes too much a hormone that leads to an imbalance of calcium levels.
• those with high calcium levels due to primary hyperparathyroidism who are not able to undergo surgery to remove the parathyroid gland
• those with high calcium levels due to parathyroid cancer

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Cinacalcet may be found in some form under the following brand names:

• Sensipar

Serious side effects have been reported. See the Drug Precautions section.

Common side effects include:

• nausea
• vomiting
• diarrhea
• numbness around the mouth, feet, or fingertips

This is not a complete list of side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins and herbal supplements.  Especially tell your doctor if you take:

• ketoconazole (Nizoral)
• itraconazole (Sporanox)
• erythromycin (EES, Erythrocin)
• metoprolol ( Toprol or Lopressor)
• carvedilol  (Coreg)
• flecainide (Tambocor)
• tricyclic antidepressants such as amitriptyline (Elavil) and desipramine (Norpramin))
• dextromethorphan (Vicks DayQuil Cough, Mucinex DM)
• atomoxetine (Strattera)

This is not a complete list of cinacalcet drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with cinacalcet, including the following:

• Cinacalcet can lower calcium levels in the blood and can cause tingling, muscle pain, muscle cramping, and convulsions.
• Cinacalcet may lower the seizure threshold in patients with a history of seizure disorders.

Do not take cinacalcet if:                        

• your blood levels of calcium are low.
• you are allergic to cinacalcet or any of its ingredients.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of cinacalcet, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking cinacalcet, tell your doctor about all of your medical conditions. Especially tell your doctor if you have a history of seizures. Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant. The FDA categorizes medications based on safety for use during pregnancy. Five categories- A,B,C,D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy. 

Cinacalcet falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans, though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

It is not known if cinacalcet crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with the use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using cinacalcet.

Take cinacalcet exactly as prescribed.

It comes in tablet form and the dosage varies. It should be taken with food or shortly after a meal.

Cinacalcet tablets should be taken whole and never split or crushed.

If you miss a dose, take the missed dose as soon as you remember. If it as almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of cinacalcet at the same time.

Take cinacalcet exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The cinacalcet dose your doctor recommends will be based on the following:

• the condition being treated
• how well you respond to this medication

The recommended starting dose of cinacalcet for secondary hyperparathyroidism in patients with chronic kidney disease on dialysis is 30 mg once a day and may be increased up to 180 mg per day.

The recommended starting dose of cinacalcet for parathyroid carcinoma or primary hyperparathyroidism is 30 mg twice a day and may be increased to 90 mg 3 or 4 times a day depending on response.

If you take too much cinacalcet call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If cinacalcet is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store cinacalcet tablets at 77˚F (excursions allowed from 59˚to 86˚F). 
• Keep this and all medications out of the reach of children.