Why is this medication prescribed?

Cinacalcet is typically prescribed for the treatment of hyperparathyroidism in patients with chronic kidney disease who are on dialysis. Hyperparathyroidism is a condition where there is excessive production of parathyroid hormone (PTH) by the parathyroid glands, which can lead to abnormalities in calcium and phosphorus levels in the blood.

• Hyperparathyroidism in Chronic Kidney Disease: Cinacalcet is used to lower elevated levels of parathyroid hormone (PTH) in patients with chronic kidney disease who are on dialysis. It helps in regulating calcium and phosphorus levels in the blood.
• Secondary Hyperparathyroidism: This drug is particularly effective in managing secondary hyperparathyroidism, which occurs as a result of kidney disease and its effects on mineral metabolism.

How should this medicine be used?

Here are some general guidelines:

• Dosage: The dosage of cinacalcet is individualized based on the patient’s condition and response to treatment. It is usually started at a low dose and gradually increased under medical supervision to achieve the desired therapeutic effect.
• Administration: Cinacalcet is typically taken orally with food or shortly after eating to enhance absorption.
• Monitoring: Patients taking cinacalcet should have their serum calcium and PTH levels monitored regularly to assess the response to treatment and adjust the dosage if necessary.
• Compliance: It is important for patients to take cinacalcet exactly as prescribed by their healthcare provider. Missing doses or taking the medication inconsistently can affect its effectiveness.
• Side Effects: Like any medication, cinacalcet can cause side effects such as nausea, vomiting, diarrhea, and dizziness. Patients should report any unusual or severe side effects to their healthcare provider.
• Special Considerations: Cinacalcet should be used with caution in patients with a history of seizures or with conditions that may predispose to seizures.

Always consult with a healthcare professional for specific instructions tailored to your medical condition and needs when using cinacalcet or any prescription medication.

Other uses for this medicine

• Primary Hyperparathyroidism: While not officially approved for this indication, cinacalcet has been studied for use in managing hypercalcemia associated with primary hyperparathyroidism.
• Calciphylaxis: There is some evidence suggesting potential benefits of cinacalcet in managing calciphylaxis, a rare and serious condition characterized by calcification of blood vessels.

What special precautions should I follow?

Special Precautions for Cinacalcet:

• Monitoring: Regular monitoring of serum calcium and phosphorus levels is crucial during treatment with cinacalcet. This helps to assess the response to treatment and adjust the dosage as needed to maintain appropriate levels.
• Liver Function: Cinacalcet is metabolized in the liver, so it should be used with caution in patients with impaired liver function. Close monitoring of liver enzymes may be necessary in these patients.
• Hypocalcemia: Cinacalcet can lower serum calcium levels, which can lead to hypocalcemia. Patients should be monitored for signs and symptoms of hypocalcemia such as numbness, tingling, muscle spasms, and seizures. Calcium and vitamin D supplementation may be required to prevent or treat hypocalcemia.
• Drug Interactions: Cinacalcet may interact with other medications, including certain antifungal agents, antibiotics, and anticonvulsants. It is important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
• Pregnancy and Breastfeeding: The safety of cinacalcet in pregnancy and breastfeeding is not well established. It should only be used if the potential benefits outweigh the risks, and under the close supervision of a healthcare provider.
• Seizure Risk: Cinacalcet may lower the seizure threshold. Patients with a history of seizures or conditions that may predispose to seizures should be closely monitored while taking cinacalcet.

Always follow your healthcare provider’s instructions regarding the use of cinacalcet and inform them of any medical conditions you have or medications you are taking to ensure safe and effective treatment.

What special dietary instructions should I follow?

• Take with Food: Cinacalcet should be taken with food or shortly after a meal. This helps with its absorption and reduces the likelihood of stomach upset.
• Maintain Consistent Calcium Intake: Try to maintain a consistent intake of calcium-rich foods in your diet. Your healthcare provider may recommend specific dietary adjustments based on your calcium levels and individual needs.
• Avoid High Calcium Supplements: While on cinacalcet, avoid taking calcium supplements unless specifically instructed by your healthcare provider. Excess calcium intake can affect the balance that cinacalcet is trying to achieve.

What should I do if I forget a dose?

If you forget to take a dose of cinacalcet, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Cinacalcet, like any medication, can cause side effects. Some common and serious side effects associated with cinacalcet include:

Common Side Effects:

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Headache
• Hypocalcemia (low calcium levels, which can cause symptoms such as muscle cramps, tingling sensations)

Less Common but Serious Side Effects:

• Severe hypocalcemia: This can lead to muscle spasms, seizures, and abnormal heart rhythms.
• Worsening heart failure: Especially in patients with a history of heart problems.
• Hepatitis: Inflammation of the liver.
• Allergic reactions: Such as rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.

Other Considerations:

• Electrolyte imbalances: Cinacalcet can affect levels of calcium, phosphorus, and magnesium in the blood, potentially leading to complications if not monitored properly.
• Gastrointestinal issues: Beyond nausea and vomiting, some patients may experience constipation or abdominal pain.
• Muscle aches or weakness: Particularly if hypocalcemia occurs.

If you experience any unusual symptoms or side effects while taking cinacalcet, it’s important to notify your healthcare provider promptly. They can assess the severity of the side effects and determine whether any adjustments to your treatment plan are necessary.

Always follow your healthcare provider’s instructions regarding the use of cinacalcet and report any concerns or changes in your health status during treatment.

What should I know about storage and disposal of this medication?

Storage and Disposal of Cinacalcet:

• Storage:
  • Store cinacalcet tablets at room temperature, away from moisture and heat.
  • Keep the medication in its original packaging or container to protect it from light.
• Disposal:
  • Dispose of unused or expired cinacalcet tablets according to local regulations and guidelines.
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
  • Ask your pharmacist or healthcare provider about the safest way to dispose of medications that are no longer needed.

In case of emergency/overdose

• Emergency Contact: In case of an overdose or emergency, such as severe dizziness, fainting, or difficulty breathing, call emergency services (911 in the US) immediately.
• Symptoms of Overdose: Symptoms of cinacalcet overdose may include severe dizziness, fainting, confusion, and muscle spasms. Seek immediate medical attention if you suspect an overdose or experience any unusual symptoms after taking cinacalcet.

What other information should I know?

• Regular Monitoring: Regularly monitor your serum calcium levels and follow-up with your healthcare provider as recommended. Report any new symptoms or changes in health status promptly to your healthcare provider.
• Medication Interactions: Inform your healthcare provider about all medications you are taking, including prescription drugs, over-the-counter medications, vitamins, and supplements. Cinacalcet can interact with other medications, potentially affecting their effectiveness or increasing the risk of side effects.
• Patient Counseling: It’s important to understand the purpose of cinacalcet treatment and adhere to your prescribed dosage schedule. Discuss any questions or concerns you have about cinacalcet with your healthcare provider or pharmacist.
• Special Populations: Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. The use of cinacalcet during pregnancy and breastfeeding should be carefully considered based on potential risks and benefits.
• Routine Healthcare Visits: Attend scheduled follow-up appointments with your healthcare provider to monitor your response to treatment and address any ongoing concerns.

By understanding these aspects of cinacalcet use, storage, disposal, emergencies, and other important information, you can better manage your treatment effectively and safely. Always consult your healthcare provider or pharmacist if you have any questions or need further clarification about your medication regimen.