Cinacalcet is used on its own or together with other medicines to treat hyperparathyroidism (high level of parathyroid hormone due to overactivity of parathyroid glands) in those with severe kidney disease who are undergoing dialysis.
This medicine is also used to reduce hypercalcaemia (high calcium level in the blood) in people with parathyroid cancer or hyperparathyroidism when surgical removal of the gland is not possible.
Take Cinacalcet exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Take it together with food or immediately after a meal. Try to take it at the same time each day.
This medicine is available as a tablet or granules in capsules for opening.
If you are taking the tablet, swallow it whole. Do not divide, chew or crush the tablet.
If you have difficulty swallowing tablet(s), you may be given the granules in capsules for opening. Open the capsule and sprinkle the granules onto a small amount of soft foods or liquids such as apple sauce, yoghurt, or apple juice. Take the mixture immediately. Using water is not advisable as it may make Cinacalcet taste bitter. Do not swallow the capsule whole.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Cinacalcet must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have hypocalcaemia (low calcium level in the blood) as Cinacalcet may not be suitable for you.
Do not take this medicine with etelcalcetide (other medicines used to treat high levels of parathyroid hormones).
Inform your doctor if you have the following conditions:
- heart problems e.g. heart rhythm disorder
- history of epilepsy (fits or seizures)
- stomach problems e.g. stomach ulcer, severe vomiting
- moderate to severe liver disease
Let your doctor know if you are pregnant or breastfeeding.
Notify your doctor if you started or stopped smoking.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine blood tests (e.g. blood calcium, phosphorus, or parathyroid hormone levels) may be done while you are being treated with Cinacalcet.
- Regular monitoring for signs and symptoms of hypocalcaemia may also be needed.
Your doctor will advise you about how often you will need to have these tests.
Cinacalcet may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, cough, nausea, vomiting, indigestion, diarrhoea, stomach pain, constipation, decreased appetite, weakness, back pain, and difficulty sleeping.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- numbness or tingling sensation in the hands and feet; muscle aches, cramps, or spasms
- fits or seizures
- chest pain, irregular or abnormal heartbeat, passing out
- pass out bloody or black as tar stools; vomiting blood, severe nausea or vomiting
- rashes, breathlessness, swelling of the face, eyes, mouth or throat
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Cinacalcet with etelcalcetide (other medicine used to treat high level of parathyroid hormone).
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. ketoconazole, itraconazole, voriconazole
- medicines to treat depression e.g. desipramine, amitriptyline, nortriptyline
- medicines for irregular heartbeat e.g. flecainide, propafenone
- medicines for high blood pressure e.g. metoprolol, carvedilol
- certain antibiotics e.g. telithromycin
- ritonavir (medicine for HIV infection)
- dextromethorphan (medicine used to relieve cough)
- rifampicin (medicine used for tuberculosis or TB)
This list does not include all medicines that may interact with Cinacalcet.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid excessive consumption of grapefruit or grapefruit juice.
Store in a cool, dry place away from the reach of children.
Protect from light and moisture.
Medicines must not be used past the expiry date.