Cinacalcet
Uses of Cinacalcet
Cinacalcet is primarily used to manage certain conditions that result in high levels of parathyroid hormone (PTH) and calcium in the blood. It belongs to a group of medicines called calcimimetics.
Apart from this primary use, Cinacalcet plays a significant role in managing secondary hyperparathyroidism in adult patients with chronic kidney disease (CKD) who are on dialysis, hypercalcemia in adult patients with parathyroid carcinoma, and severe hypercalcemia in adult patients with primary hyperparathyroidism who are unable to undergo parathyroidectomy. It is also used for treatment of secondary hyperparathyroidism (HPT) in children aged 3 years and older with end-stage renal disease (ESRD) on maintenance dialysis therapy in whom secondary HPT is not adequately controlled with standard of care therapy.
Side effects of Cinacalcet
Nausea and vomiting
Muscle spasms or stiffness
Dizziness
Decreased appetite
Fatigue or weakness
How Cinacalcet works
Cinacalcet is a calcimimetic.
It works by modulating the calcium-sensing receptors (CaSR) on the chief cells of the parathyroid gland, making them more sensitive to calcium. This leads to a decrease in the production and release of parathyroid hormone (PTH).
Certified content
Written By
BDS, MDS
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Cinacalcet is available for oral administration (tablets).
Age and Dose Restrictions
Cinacalcet is intended for use in adults, and children aged 3 and above.
Contraindications
The use of Cinacalcet is contraindicated in patients with a known hypersensitivity to any components of the product.
Initiation of treatment with Cinacalcet is contraindicated if serum calcium levels are below the lower limit of normal.
Other Medications to Avoid
Cinacalcet may interact with strong inhibitors of CYP2D6 (such as paroxetine, fluoxetine, and quinidine), enzymes (such as desipramine, metoprolol, and carvedilol) and strong inhibitors of CYP3A4 (like ketoconazole, and itraconazole).
Overdose and Missed Dose
Overdose symptoms may include hypotension, hypocalcaemia, nausea, and vomiting. In cases of suspected overdose, patients should be monitored for signs and symptoms of these conditions.
If a dose is missed, it should be taken as soon as the patient remembers. However, if it is close to the time for the next dose, the missed dose should be skipped.
Management of Side Effects
Most side effects seen with Cinacalcet are temporary and generally harmless. They tend to resolve by discontinuing the medicine. However, if you experience any severe side effects or worsening of any symptoms, please consult your doctor.
Drinking plenty of water can help manage side effects like nausea and vomiting.
To manage dizziness or lightheadedness caused by low blood pressure, sit or lie down until the symptoms pass.
Use in Driving and Operating Machinery
As Cinacalcet can cause dizziness, caution is advised when driving or operating machinery.
Use in Pregnancy and Lactation
It should be used during these periods only if the potential benefit justifies the potential risk to the baby. Always consult your doctor before taking this medication during pregnancy or while breastfeeding.
Caution in Other Conditions
Patients with a history of seizures or those taking anti-seizure medications should exercise caution while using Cinacalcet, as it may increase their risk of seizures.
Caution should also be exercised in patients with risk factors for upper gastrointestinal bleeding, such as known gastritis, esophagitis, ulcers, or severe vomiting.
Special Dietary and Lifestyle Recommendations
Patients with conditions causing high levels of parathyroid hormone (PTH) and calcium in the blood should ensure they are eating a balanced diet rich in calcium and vitamin D to aid in maintaining healthy bone structure.
Regular monitoring of serum calcium levels is recommended to avoid severe hypocalcaemia.
Frequently asked questions
Can I become dependent on Cinacalcet?
Cinacalcet does not cause medicine dependence. However, you should always take it as directed by your doctor and not stop abruptly without consulting them.
Is it safe for me to take Cinacalcet if I am hypersensitive to some medicines?
You should avoid taking Cinacalcet if you have a known hypersensitivity to any of its components. Always consult your doctor before starting any new medication.
Are there other medications similar to Cinacalcet?
Yes, there are other medications that belong to the same class as Cinacalcet, known as calcimimetics. However, only your doctor can determine which medication is best for you based on your medical history and health condition.
Can I experience muscle spasms while on Cinacalcet?
Yes, muscle spasms are a common side effect of Cinacalcet and may be experienced by some patients.
Can I develop a rash or itching due to Cinacalcet?
Yes, some patients on Cinacalcet have reported experiencing pruritus (itching) and developing a rash.
Will Cinacalcet have an impact on my mood?
There are no direct indications that Cinacalcet impacts mood. However, if you observe any changes in your mood or behaviour after starting this medicine, consult your doctor immediately.
Is it necessary to have food before taking Cinacalcet?
Yes, it is recommended that Cinacalcet should be taken with food or shortly after a meal.
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