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Cinacalcet Dosage

Medically reviewed by Drugs.com. Last updated on Jul 9, 2024.

Applies to the following strengths: 90 mg; 60 mg; 30 mg

Usual Adult Dose for Secondary Hyperparathyroidism

Initial dose: 30 mg orally once a day
Titration: The dose should be titrated no more frequently than every 2 to 4 weeks through sequential doses of 30, 60, 90, 120, and 180 mg orally once a day to target iPTH levels of 150 to 300 pg/mL. (Serum iPTH levels should be assessed no earlier than 12 hours after dosing)
Maximum dose: 180 mg orally once a day

Comments:


Use: Secondary Hyperparathyroidism: For the treatment of secondary hyperparathyroidism (HPT) in adult patients with chronic kidney disease (CKD) on dialysis. (This drug is not indicated for use in adult patients with CKD who are not on dialysis because of an increased risk of hypocalcemia)

Usual Adult Dose for Hypercalcemia of Malignancy

Initial dose: 30 mg orally twice a day
Titration: Titrate dose every 2 to 4 weeks through sequential doses of 30 mg orally twice a day, 60 mg orally twice a day, 90 mg orally twice daily, and 90 mg 3 or 4 times a day
Maintenance dose: 60 to 360 mg orally per day
Maximum dose: 90 mg orally 4 times a day

Comments:


Use: Parathyroid carcinoma and primary hyperparathyroidism who are unable to undergo parathyroidectomy

Usual Adult Dose for Primary Hyperparathyroidism

Initial dose: 30 mg orally twice a day
Titration: Titrate dose every 2 to 4 weeks through sequential doses of 30 mg orally twice a day, 60 mg orally twice a day, 90 mg orally twice daily, and 90 mg 3 or 4 times a day
Maintenance dose: 60 to 360 mg orally per day
Maximum dose: 90 mg orally 4 times a day

Comments:


Use: Parathyroid carcinoma and primary hyperparathyroidism who are unable to undergo parathyroidectomy

Renal Dose Adjustments

No dose adjustment recommended

Liver Dose Adjustments

Moderate to severe hepatic impairment increases concentrations of this drug by approximately 2 to 4 fold. In patients with moderate-severe hepatic impairment, PTH and serum calcium concentrations should be closely monitored during dose titration.

Dose Adjustments

For secondary hyperparathyroidism patients with CKD on dialysis, if serum calcium falls below 8.4 mg/dL but remains above 7.5 mg/dL, or if symptoms of hypocalcemia occur, calcium-containing phosphate binders and/or vitamin D sterols can be used to raise serum calcium. If serum calcium falls below 7.5 mg/dL, or if symptoms of hypocalcemia persist and the dose of vitamin D cannot be increased, therapy should be withheld until serum calcium levels reach 8 mg/dL and/or symptoms of hypocalcemia have resolved. Treatment should be reinitiated using the next lowest dose.

Precautions

This drug is not recommended for use in children.

Consult WARNINGS section for additional precautions.

Dialysis

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.