Sensipar (Cinacalcet) - Oral

What Is Sensipar?

Sensipar (cinacalcet) is a medication taken by mouth (oral) to lower calcium levels in adults with primary hyperparathyroidism and parathyroid cancer. It is also used to treat adults with secondary hyperparathyroidism who have chronic kidney disease and are on dialysis.

Sensipar belongs to a group of drugs called calcimimetics. It works by lowering parathyroid hormone (PTH) levels, which become too high in people with hyperparathyroidism and parathyroid cancer.

Too much PTH causes calcium levels in the body to rise. High calcium can lead to both short-term and long-term health problems, including problems with the bones, heart, blood vessels, and lungs. Sensipar helps normalize calcium levels by decreasing PTH.

What Is Sensipar Used For?

Sensipar is an oral medication used to treat adults with:

• Secondary hyperparathyroidism who have chronic kidney disease and are on dialysis
• High calcium (hypercalcemia) levels due to primary hyperparathyroidism who cannot have their overactive parathyroid gland(s) removed surgically (parathyroidectomy)
• High calcium (hypercalcemia) levels due to parathyroid cancer
  

The parathyroid is a set of four glands in the neck behind the thyroid. The parathyroid glands release a hormone called parathyroid hormone (PTH). PTH helps control the amount of calcium in the blood. Too much PTH is secreted into the blood when the parathyroid glands become overactive from hyperparathyroidism or parathyroid cancer. This causes calcium levels to rise.

Many people with hyperparathyroidism do not have symptoms at first. However, as calcium levels begin to rise, nonspecific symptoms may occur, including:

• Joint aches
• Fatigue
• Weakness
• Loss of appetite
• Mild depression
• Difficulty concentrating

If their calcium and PTH levels continue to increase, a person may develop a significant loss of appetite, nausea, constipation, excessive thirst, or frequent urination.

Without treatment, serious health problems can occur, including issues with the kidneys, bones, joints, heart, blood vessels, and lungs.

Sensipar is one medication that can help normalize PTH and calcium blood levels.

How to Take Sensipar

Sensipar is available as an oral tablet. Typically, healthcare providers prescribe Sensipar once daily, but you may need to take it twice a day, depending on your condition. Sensipar should be taken with food or shortly after a meal. If possible, try to take your Sensipar dose at the same time each day with the same meal.

Sensipar tablets should always be swallowed whole. Do not chew, crush, or divide the tablets.

Storage

Store Sensipar at room temperature. Do not store it in the bathroom. Keep Sensipar and all your medicines in a safe location, out of the reach of children and pets.

What are the Side Effects of Sensipar?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

You may experience side effects while taking Sensipar. Tell your healthcare provider about any side effects that bother you or do not go away.

Common side effects include:

• Nausea
• Vomiting
• Diarrhea
• Dizziness
  

Severe Side Effects

Sensipar may cause serious side effects. Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious side effects and their symptoms include:

• Low calcium (hypocalcemia). This can cause severe and life-threatening reactions. Contact your healthcare provider right away if you develop:
• Burning, tingling, or unusual feelings in the lips, tongue, fingers, or feet
• Muscle aches or pains
• Muscle spasms
• Seizures
• An unusual heart rhythm
• Gastrointestinal bleeding. Let your provider know if you experience worsening nausea or vomiting or if you notice signs of bleeding, such as bloody vomit, vomit that looks like coffee grounds, or black and tarry stool.
• Worsening of heart failure. Sensipar can make heart failure worse. Contact your healthcare provider if you have difficulty breathing, swelling, or rapid weight gain.
  

Dosage: How Much Sensipar Should I Take?

Modifications

The following modifications (changes) should be kept in mind when using Sensipar:

Severe allergic reaction: Avoid using Sensipar if you have a known allergy to it or any of the ingredients in it. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, Sensipar was found to have harmful effects on the fetus. We don't know enough about the safety and effectiveness of Sensipar in pregnant people and their fetuses. Let your healthcare provider know if you're pregnant or plan to become pregnant, and talk to them about the benefits and risks of taking Sensipar during your pregnancy.

Breastfeeding: In animal studies, Sensipar was present in rat breastmilk. We don't know enough about the safety of Sensipar in human breastmilk and nursing babies. Talk with your healthcare provider if you plan to breastfeed. You can weigh the benefits and risks of taking Sensipar while nursing and go over the different ways to feed your baby.

Adults over 65: In clinical studies, people in this age group did not respond differently from younger adults. However, some older adults might be more sensitive to Sensipar's side effects.

Children: The safety and effectiveness of using Sensipar in children have not been established. Sensipar is not approved to treat children.

Liver problems: People with liver problems may not be able to clear medications from their bodies as quickly. This means the medicine stays in the body longer and can have increased side effects. If you have moderate to severe liver impairment and are taking Sensipar, your healthcare provider will closely monitor your blood levels of calcium, phosphorus, and parathyroid hormone.

Missed Dose

If you accidentally forgot your Sensipar dose, take it as soon as you remember. If it's already close to your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Do not "double up" to make up for the missed dose.

Try to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Sensipar might be less effective at treating your condition.

Overdose: What Happens If I Take Too Much Sensipar?

The symptoms of a Sensipar overdose may include the following:

• Burning, tingling, or unusual feelings in the lips, tongue, fingers, or feet
• Muscle aches or pains
• Muscle spasms
• Seizures
• An unusual heart rhythm

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn’t Take Sensipar?

Do not take Sensipar if you have low calcium levels in your blood. Your healthcare provider will monitor your calcium levels with a blood test before starting Sensipar and during treatment.

What Other Medications Interact With Sensipar?

Use caution when taking Sensipar with the following medications:

• Certain HIV medications
• Clarithromycin 
• Ketoconazole 
• Nefazodone 
• Noxafil (posaconazole)
• Sporanox (itraconazole)
• Vfend (voriconazole)
• Tricyclic antidepressants, such as Norpramin (desipramine), amitriptyline, and Silenor (doxepin)
• Certain beta-blockers, such as Toprol XL (metoprolol), Coreg (carvedilol), Bystolic (nebivolol), and Inderal XL (propranolol)
• Flecainide
• Thioridazine
• Tamoxifen
• Amphetamines, such as Dexedrine (dextroamphetamine), Vyvanse (lisdexamfetamine), and Adderall (dextroamphetamine and amphetamine)
• Aristada (aripiprazole lauroxil)
• Rexulti (brexpiprazole)
• Clozaril (clozapine)
• Products that contain dextromethorphan
• Haldol (haloperidol)
• Reglan (metoclopramide)
• Paxil (paroxetine)
• Perphenazine
• Pimozide
• Rythmol SR (propafenone)
• Risperdal (risperidone)
• Prograf (tacrolimus)
• Flomax (tamsulosin)
• Trintellix (vortioxetine)
  

Many other medications may interact with Sensipar. Be sure to inform your healthcare provider about all the medicines you take, including over-the-counter (OTC), nonprescription products, vitamins, and herbal supplements.

What Medications Are Similar?

Sensipar belongs to a group of drugs called calcimimetics. Other calcimimetics include:

• Parsabiv (etelcalcetide)

Parsabiv is only approved to treat secondary hyperparathyroidism in people with chronic kidney disease on dialysis. Unlike Sensipar, Parsabiv is an intravenous (IV) medication given three times per week at the end of a dialysis session.

You and your healthcare provider will work together to choose the best treatment for you.

How Can I Stay Healthy While Taking Sensipar?

If your parathyroid has become overactive, Sensipar is one medication option that your healthcare provider can prescribe. While living with an overactive parathyroid has its challenges, there are ways to help improve your quality of life. Refer below for some general tips to support your health:

• Take parathyroid-related medications as recommended by your healthcare provider.
• Do not start taking any medicines—especially OTC calcium or vitamin D supplements, vitamin and herbal supplements—without talking with your healthcare provider first.
• Follow up with all blood tests your healthcare provider has ordered. Monitoring your blood levels of calcium and parathyroid hormone is essential to managing your condition.
• Work with your healthcare provider to develop a healthy eating plan and exercise regimen to support your health. Discuss a referral to a registered dietitian nutritionist.