Cinacalcet Disease Interactions

Cinacalcet lowers serum calcium, and therefore patients should be carefully monitored for the occurrence of hypocalcemia. Potential manifestations of hypocalcemia include paresthesias, myalgias, cramping, tetany, and convulsions. Cinacalcet treatment should not be initiated if serum calcium is less than the lower limit of the normal range (8.4 mg/dL). Monitor serum calcium 1 week after treatment initiation or dose adjustment, and once every month once the maintenance dose has been established.

Postmarketing safety surveillance studies have reported cases of hypotension, worsening heart failure and/or arrhythmias in patients with impaired cardiac function receiving cinacalcet. A causal relationship could not been excluded and this may be mediated by reductions in serum calcium. Cinacalcet should be used with caution in patients with hypotension or preexisting impaired cardiac function.

Cinacalcet may lower seizure threshold in patients with a history of seizures. Serum calcium levels should be closely monitored in patients receiving cinacalcet, particularly in patients with history of seizure disorders.