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Brand names: Sensipar • Drug class: Calcimimetic
Cinacalcet lowers PTH directly by sensitizing the calcium-sensing receptor — used when secondary hyperparathyroidism persists despite vitamin D and binders. It also treats hypercalcemia in parathyroid carcinoma. In dialysis, it's the standard agent for severe uncontrolled PTH.
Cinacalcet acts on the parathyroid gland, not the kidney — no renal dose adjustment needed at any eGFR. In dialysis patients with severe secondary hyperparathyroidism, it lowers PTH and, in the EVOLVE trial, was associated with cardiovascular benefit signals. Key monitoring: calcium (it can cause hypocalcemia), PTH, and symptoms of hypocalcemia.
EVOLVE trial: cinacalcet reduced clinical fractures and cardiovascular events in secondary analysis
EVOLVE (EVOLVE Trial Investigators, NEJM 2012), 2012
Lowers PTH in dialysis patients with secondary hyperparathyroidism
Pivotal trials, 2004
No renal dose adjustment. Start 30 mg once daily; titrate every 2-4 weeks to PTH target (max 180 mg/day). Check calcium and PTH 1-2 weeks after each dose change. Correct low calcium before starting.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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