Formulary
Cinacalcet: Indications, Dosing, Side Effects and Interactions
Cinacalcet reduces parathyroid hormone which leads to a decrease in serum calcium concentrations.
MedNext Academy | 3 min read
Cinacalcet: Indications, Dosing, Side Effects and Interactions
Cinacalcet reduces parathyroid hormone which leads to a decrease in serum calcium concentrations.
Drug action
Cinacalcet reduces parathyroid hormone which leads to a decrease in serum calcium concentrations.
Indications and dose
**Secondary hyperparathyroidism [in patients with end-stage renal disease on dialysis] (under expert supervision)**
- **Adult** (By Mouth): Initially 30 mg once daily, increased if necessary up to 180 mg once daily, dose to be adjusted every 2-4 weeks according to response.
**Hypercalcaemia in parathyroid carcinoma,Primary hyperparathyroidism [in patients where parathyroidectomy is inappropriate]**
- **Adult** (By Mouth): Initially 30 mg twice daily, increased if necessary up to 90 mg 4 times a day, dose to be adjusted every 2-4 weeks according to response.
**Secondary hyperparathyroidism [in patients with end-stage renal disease on dialysis] (under expert supervision) for cinacalcet**
- **Child 3-17 years** (By mouth): (consult product literature).
Cautions
Conditions that may worsen with a decrease in serum-calcium concentrations; switching from etelcalcetide Cautions, further information Conditions that may worsen with a decrease in serum-calcium concentrations Manufacturer advises caution with use in patients with conditions that may worsen with a decrease in serum-calcium concentrations, including predisposition to QT-interval prolongation, history of seizures, and history of impaired cardiac function-serum-calcium concentration should be closely monitored. Switching from etelcalcetide Manufacturer advises that in patients who have discontinued etelcalcetide, do not initiate cinacalcet until at least three subsequent haemodialysis sessions are completed, and serum-calcium concentration is confirmed within normal range.
Contraindications
Hypocalcaemia
Side effects
Common or very common Appetite decreased; asthenia; back pain; constipation; cough; diarrhoea; dizziness; dyspnoea; electrolyte imbalance; gastrointestinal discomfort; headache; hypersensitivity; hypotension; muscle complaints; nausea; paraesthesia; rash; seizure; upper respiratory tract infection; vomiting Frequency not known Heart failure aggravated; QT interval prolongation; ventricular arrhythmia
Interactions
**Other interactions (3):**
- Amiodarone, flecainide and propafenone, sertraline, bupropion, methadone, cinacalcet, haloperidol, perphenazine and thioridazine also have similar effects on the metabolism of dextromethorphan.
- As a reduced effect of tamoxifen cannot be excluded, co-administration with potent CYP2D6 inhibitors (e.g.
- In vitro studies with the following active substances did not show any relevant interaction: acetylsalicylic acid, cephalexin, cinacalcet, ciprofloxacin, clopidogrel, enalapril, hydrochlorothiazide,...
Pregnancy
Manufacturer advises use only if potential benefit outweighs risk-no information available.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate to severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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