cinacalcet hydrochloride at a glance
Medicine class
Calcimimetic; an anti-parathyroid agent.
Food
Take with food or shortly after eating.
Monitoring
Regular calcium and parathyroid hormone blood tests are important because calcium can fall too low.
What is cinacalcet hydrochloride used for?
Licensed uses represented by the selected products are:
Secondary hyperparathyroidism in adults with end-stage kidney disease receiving maintenance dialysis.
Secondary hyperparathyroidism in children aged 3 years and older receiving maintenance dialysis when standard care has not adequately controlled it.
Reduction of hypercalcaemia in adults with parathyroid carcinoma.
Reduction of hypercalcaemia in adults with primary hyperparathyroidism when parathyroid surgery would otherwise be indicated but is unsuitable or contraindicated.
How does cinacalcet hydrochloride work?
Cinacalcet increases the sensitivity of calcium-sensing receptors on parathyroid gland cells. This reduces parathyroid hormone release and blood calcium.
cinacalcet hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 30 mg, 60 mg, 90 mg
How to take cinacalcet hydrochloride
Take cinacalcet exactly as prescribed, with food or shortly after eating.
Do not chew or crush film-coated tablets.
Open granule capsules and give all the granules in suitable soft food or liquid; do not swallow the capsule shell.
Give a prepared granule mixture immediately and ensure all of it is swallowed.
Do not combine different granule strengths because this increases the risk of error.
Granules may be administered through a compatible nasogastric or gastrostomy tube when directed by the clinical team.
cinacalcet hydrochloride side effects
Common or expected effects
- Nausea or vomiting
- Reduced appetite, indigestion, abdominal pain, diarrhoea or constipation
- Dizziness, headache or tingling
- Muscle pain, spasms, back pain or weakness
- Rash
- Low blood pressure
- Low blood calcium
Get urgent medical advice
- Low calcium causing marked tingling around the mouth, muscle cramps, spasms, seizures, confusion or loss of consciousness
- Swelling of the face, lips, tongue or throat, particularly with breathing or swallowing difficulty
- Fast or pounding heartbeat associated with low calcium
- New or worsening symptoms of heart failure
cinacalcet hydrochloride in pregnancy
Human pregnancy data are limited. A specialist or prescriber should weigh the expected benefit against possible fetal risk. Discuss treatment if pregnant or planning pregnancy rather than stopping it independently.
cinacalcet hydrochloride while breastfeeding
It is unknown whether cinacalcet enters human milk. A specialist benefit–risk assessment is needed to decide whether breastfeeding or treatment should be interrupted.
cinacalcet hydrochloride interactions
Check all prescribed, over-the-counter and complementary products before starting or stopping them.
Etelcalcetide
Do not use concurrently because the combination may cause severe hypocalcaemia.
Other medicines that lower calcium
May add to cinacalcet's effect and require closer calcium monitoring.
Strong CYP3A4 inhibitors or inducers, including azole antifungals, ritonavir and rifampicin
Can alter cinacalcet exposure, so treatment should be reviewed when they are started or stopped.
Common questions about cinacalcet hydrochloride
Answers are fully visible for fast scanning and source review.
Why are blood tests needed?
Cinacalcet can lower calcium too far. Calcium and, for secondary hyperparathyroidism, parathyroid hormone measurements also assess its effect.
What are the warning signs of low calcium?
Warning signs include tingling around the mouth or in the fingers and toes, muscle cramps, twitching or spasms. Seizures, confusion, loss of consciousness or an abnormal heartbeat require urgent assessment.
Can cinacalcet affect driving?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.