Cinacalcet
About Cinacalcet
Cinacalcet is an oral prescription medicine used to lower high levels of parathyroid hormone in people with long-term kidney disease who are on dialysis. It is also used to reduce high calcium levels in the blood for people with parathyroid gland tumours or overactive parathyroid glands who cannot have surgery. By keeping these hormone and mineral levels in balance, it helps protect your bones and blood vessels from damage.
You should take Cinacalcet consistently every day, exactly as your doctor directs. It is best to take this medicine with food or shortly after eating a meal, as this helps your body absorb the medicine properly. Alongside this treatment, your doctor may recommend specific dietary adjustments, such as limiting foods high in phosphorus or managing your calcium intake, to help you get the best results.
While taking Cinacalcet, you may experience common mild side effects like nausea or vomiting. However, it is vital to contact your doctor immediately if you experience signs of low blood calcium, such as muscle spasms, numbness, tingling around your mouth, or a fast, pounding heartbeat. Always consult your doctor if you experience any persistent or severe side effects during your treatment.
Before starting Cinacalcet, tell your doctor if you have a history of seizures, heart failure, liver problems, or abnormal heart rhythms. Do not take this if you already have low calcium levels in your blood, as this medicine will lower them further and could cause serious health complications.
This medicine can interact with other drugs, particularly certain heart medicines or antidepressants, which can alter how your body processes them. Additionally, smoking can speed up how quickly your body clears this medicine, potentially making it less effective. If you are pregnant, breastfeeding, or planning a family, talk to your doctor or pharmacist to carefully weigh the risks and benefits before starting treatment.
Uses of Cinacalcet
Medicinal Benefits
Cinacalcet helps lower high parathyroid hormone levels in people with chronic kidney disease or certain parathyroid disorders, supporting healthier bones and mineral balance.
The following are the benefits of Cinacalcet:
- Helps prevent calcium from being removed from your bones, reducing bone pain and lowering the risk of fractures.
- Keeps calcium and phosphorus levels in a healthy range, reducing mineral buildup in your blood vessels and heart and helping protect your cardiovascular health.
- Supports long-term health during dialysis by controlling parathyroid hormone and mineral levels, helping reduce complications associated with chronic kidney disease.
Directions for Use
- Cinacalcet should be taken with food or shortly after a meal.
- It is usually taken 1-2 times daily, depending on the medical condition or as prescribed by a doctor.
- Swallow Cinacalcet as a whole with a glass of water.
- Do not crush, chew, or break it.
Storage
Side Effects of Cinacalcet
Common Side Effects (Usually mild):
- Nausea and vomiting
- Loss of appetite or upset stomach
- Diarrhoea
- Muscle pain or weakness
- Dizziness or headache
Serious Side Effects (Call a doctor right away):
- Signs of low blood calcium, such as numbness or tingling around the mouth, muscle spasms, cramping, or seizures
- A fast, slow, or irregular heartbeat
- Severe, persistent vomiting or diarrhoea leading to dehydration
- Signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, or difficulty breathing
Medicines Containing this Salt
View AllDrug Warnings
- Know the warning signs of low calcium: Before starting, make sure you and your family can recognise the signs of low blood calcium, such as tingling fingers, muscle cramps, or twitching, and seek help immediately if they occur.
- Check your heart health: Let your doctor know if you have an irregular heart rhythm, as low calcium levels can worsen this condition.
- Monitor for stomach bleeding: If you have a history of stomach ulcers or gastrointestinal bleeding, inform your doctor immediately if you notice black, tarry stools or vomit that looks like coffee grounds.
- Do not share your medicine: This prescription is strictly individualised based on your specific blood chemistry and should never be shared with others.
Drug Interactions
- Medicines metabolised by the CYP2D6 enzyme (e.g., metoprolol for blood pressure, flecainide for heart rhythm, amitriptyline for depression): Cinacalcet can increase the levels of these drugs in your body and raise the risk of side effects. Your doctor may need to adjust their doses.
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): Certain antifungals and antibiotics can slow down how your body breaks down Cinacalcet, potentially raising its levels and increasing the risk of side effects.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionCinacalcet with alcohol may cause unpleasant effects. So please consult your doctor before taking Cinacalcet with alcohol.
Pregnancy
cautionCinacalcet is not recommended for use in pregnant women unless necessary. Before taking this medicine, the risks and benefits should be discussed with the doctor.
Breast Feeding
cautionCinacalcet is not recommended for use in breastfeeding women unless necessary. Before taking this medicine, the risks and benefits should be discussed with the doctor. Your doctor may advise you to discontinue the medicine or breastfeeding based on your clinical condition.
Driving
cautionCinacalcet may cause blurred vision, dizziness, and drowsiness in some patients. You are advised not to perform any activities, such as driving a vehicle or operating machinery, if you experience any of these symptoms during treatment with this medicine.
Liver
cautionCinacalcet should be used with caution in patients with liver disease. A dose adjustment of Cinacalcet may be needed in some cases. So, please consult your doctor.
Kidney
cautionCinacalcet is not recommended for use in patients suffering from chronic kidney disease who are not being treated with dialysis due to the increased risk of hypocalcemia (low blood calcium levels). Depending on your clinical condition, dose adjustments or replacement with a suitable alternative drug should be considered.
Children
cautionCinacalcet should not be used in children below 12 years of age unless prescribed by a doctor.
Habit Forming
Diet & Lifestyle Advise
- Monitor your calcium intake: Speak with your dietitian or doctor before taking any calcium supplements, antacids containing calcium, or eating large amounts of dairy, as your calcium levels need to be closely regulated.
- Follow a low-phosphorus diet: If you are on dialysis, limit foods high in phosphorus (such as nuts, seeds, dark colas, and processed foods) to help Cinacalcet manage your mineral levels more effectively.
- Stay hydrated: If you have high calcium levels due to parathyroid cancer or primary hyperparathyroidism, drink plenty of fluids as directed by your doctor to help your kidneys flush out excess calcium.
- Attend all blood test appointments: Regular blood tests are essential to measure your calcium, phosphorus, and parathyroid hormone levels, allowing your doctor to keep your treatment safe and effective.
Special Advise
- Monitor your calcium levels regularly during treatment with Cinacalcet. Inform your doctor if you notice signs of low calcium levels, such as numbness or tingling around the mouth or muscle aches.
Patients Concern
Disease/Condition Glossary
Hyperparathyroidism: Hyperparathyroidism is a condition in which one or more of your parathyroid glands become overactive and release (secrete) too much parathyroid hormone (PTH). This causes the levels of calcium in your blood to rise, a condition known as hypercalcemia. There are two types of hyperparathyroidism: primary and secondary.
Primary hyperparathyroidism: Primary hyperparathyroidism is a condition in which one or more parathyroid glands make too much parathyroid hormone (PTH). This can lead to the loss of bone tissue. Symptoms include constipation, frequent urination, increased thirst, joint pain, kidney pain (due to kidney stones), loss of appetite, and muscle weakness.
Secondary hyperparathyroidism: Secondary hyperparathyroidism is the medical condition of excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcemia (low blood calcium levels), with resultant hyperplasia (increase in the number of cells) of these glands. This disorder is primarily seen in patients with chronic kidney failure. Symptoms include muscle pain and weakness.
Parathyroid cancer: Parathyroid cancer is a rare disease in which malignant (cancer) cells form in the tissues of a parathyroid gland. Symptoms include weakness, tiredness, nausea, vomiting, loss of appetite, weight loss for no known reason, being much more thirsty than usual, urinating much more than usual, and constipation.
FAQs
Cinacalcet is used to treat primary hyperparathyroidism, secondary hyperparathyroidism, and parathyroid carcinoma.
Cinacalcet works by signalling the body to produce less parathyroid hormone to decrease the amount of calcium in the blood.
Cinacalcet is not recommended for use in patients suffering from chronic kidney disease who are not being treated with dialysis due to the increased risk of hypocalcemia (low blood calcium levels). Replacement with a suitable alternative should be considered based on the clinical condition.
If you have hypotension (low blood pressure) and hypocalcemia (low calcium levels in the blood), please contact a doctor before taking Cinacalcet.
Cinacalcet should be used with extreme caution in patients suffering from seizures due to the increased risk of worsening their condition. Please consult your doctor before taking Cinacalcet.
Cinacalcet may cause diarrhoea. Drink plenty of fluids and eat non-spicy food if you experience diarrhoea. Consult the doctor if the diarrhoea persists or worsens.
Sometimes lactose is used in medicines. Inform the doctor if you have sugar/lactose intolerance. Check the label to know if Cinacalcet contains lactose.
Cinacalcet may cause common side effects like vomiting, nausea, rash, headache, muscle pain, and diarrhoea. If the side effects persist or worsen, consult a doctor.
Take Cinacalcet exactly as prescribed by your doctor. It should be taken with food or shortly after a meal, preferably at the same time each day. Taking it with food improves absorption and helps reduce stomach upset. Avoid taking it on an empty stomach. If you have difficulty following these instructions, consult your doctor or pharmacist.
Signs of low blood calcium include tingling or numbness around your mouth, fingers, or toes, muscle cramps, spasms, and, in severe cases, seizures. If you experience any of these symptoms, contact your doctor right away.
No, you should always swallow Cinacalcet tablets whole. Do not crush, chew, split, or break them, as doing so can change how quickly the medicine is released into your system. Talk to your doctor or pharmacist if you have difficulty swallowing pills.
Yes, you will need frequent blood tests to monitor your calcium, phosphorus, and parathyroid hormone levels. These tests help your doctor ensure the medicine is working safely and determine if your dose needs to be adjusted. Talk to your doctor about your testing schedule.
There is limited research on the safety of Cinacalcet during pregnancy or breastfeeding. You should discuss the potential risks and benefits with your healthcare provider before starting this medication. Talk to your doctor if you are pregnant or planning to become pregnant.
No, Cinacalcet does not cure kidney disease. Instead, it helps manage one of the serious complications of long-term kidney disease by controlling your parathyroid hormone and mineral levels to protect your bones and blood vessels. Talk to your doctor to understand your overall treatment plan.
Nausea is a common side effect of Cinacalcet, especially when you first start taking it. Taking your dose exactly with a meal can help reduce stomach upset. If the nausea is severe, persistent, or prevents you from eating, talk to your doctor or pharmacist.
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