Adult Dosing
Secondary Hyperparathyroidism in CKD patients on dialysis
- Start 30 mg PO daily
- Titrate q2-4 wks through sequential doses of 60, 90, 120, and 180 mg PO daily to achieve a target parathyroid hormone (iPTH) between 150-300 pg/mL in dialysis patients
Parathyroid carcinoma, severe hypercalcemia with primary hyperparathyroidism
- Start 30 mg PO bid
- Titrate q2-4 wks through sequential doses of 30, 60, 90 mg PO bid to achieve normal serum calcium levels
- Max: 90 mg PO tid-qid to normalize serum calcium levels
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Do not initiate therapy if serum level is less than the normal range (8.4 mg/dL). To raise the serum calcium level use calcium-containing phosphate binders and/or vitamin D sterols
- Withhold treatment if serum calcium falls below 7.5 mg/dl or if symptoms of hypocalcemia persist and the dose of Vitamin D cannot be increased
- Generalized or tonic-clonic seizures have been observed in patient
- Closely monitor the serum calcium levels in patients with a history of a seizure disorder receiving the drug therapy
- Idiosyncratic cases of hypotension, worsening heart failure and/or arrhythmia in patient with cardiac dysfunction have been reported in postmarketing safety surveillance
- Cinacalcet lowers serum calcium, therefore measure serum calcium and monitor for the signs of hypocalcemia viz paresthesias, myalgias, cramping, tetany and convulsions
- Risk for hypocalcemia increases with CKD patients not on dialysis, so it is not recommended in such patient
- Adynamic bone disease may develop if iPTH levels are suppressed below 100 pg/mL
- Patients with CKD on Dialysis with Secondary Hyperparathyroidism: Measure serum calcium and serum phosphorus within 1 wk of starting therapy or at the time of dose adjustments. Once stable, monitor qmo; if seizure history or mod-severe hepatic impairment then frequently
- Patients with Parathyroid Carcinoma: Measure serum calcium within 1 wk of starting therapy or at the time of dose adjustments. Once stable, monitor every 2 months; if seizure history or mod-severe hepatic impairment then frequently
Cautions: Use cautiously in
- History of seizure disorder
- Cardiac disorder
- Hepatic impairment
Supplemental Patient Information
- Drug should be taken with food or shortly after a meal. Tablets should be taken whole and should not be divided
Pregnancy Category:C
Breastfeeding: Manufacturer recommends discontinuation of breastfeeding, or discontinuation of treatment taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Sensipar 30 MG TABS [Bottle] (AMGEN)
30 mg = $449
90 mg = $1303.91 - Sensipar 60 MG TABS [Bottle] (AMGEN)
30 mg = $935.03
90 mg = $2655.01 - Sensipar 90 MG TABS [Bottle] (AMGEN)
30 mg = $1304.06
90 mg = $3859.85
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
