Indications: for the treatment of secondary hyperparathyroidism in dialysis patients with end-stage renal disease. For primary hyperparathyroidism in patients where parathyroidectomy is inappropriate.

Treatment of hypercalcaemia in parathyroid carcinoma. Cinacalcet reduces parathyroid hormone which leads to a decrease in serum calcium concentrations.

Cautions: treatment should not be initiated in patients with hypocalcaemia dose adjustment may be necessary if smoking started or stopped during treatment caution in moderate to severe impairment—monitor closely especially when increasing dose.

Note: All patients receiving pharmacological doses of vitamin D should have their plasma-calcium concentration checked at intervals (initially once or twice weekly) and whenever nausea or vomiting occur.

Side Effects: nausea, vomiting, anorexia; dizziness, paraesthesia, asthenia; reduced testosterone concentrations; myalgia; rash.

Dose: Secondary hyperparathyroidism in patients with end-stage renal disease on dialysis, ADULT over 18 years, initially 30 mg once daily, adjusted every 2–4 weeks to max. 180 mg daily. Hypercalcaemia of primary hyperparathyroidism or parathyroid carcinoma, ADULT over 18 years, initially 30 mg twice daily, adjusted every 2–4 weeks according to response up to max. 90 mg 4 times daily.