Cinacalcet is a prescription drug that is primarily used to balance unrealistically high parathyroid hormone (PTH), calcium, and phosphorus levels in the body. It is called a calcimimetic and that is, it imitates calcium in the body and aids in PTH features. Cinacalcet is also prescribed to individuals with chronic kidney disease or some parathyroid issues.
USES OF CINACALCET
Cinacalcet has the most frequent application in the treatment of secondary hyperparathyroidism (elevated PTH levels) in individuals with chronic kidney disease (CKD) and more so those receiving dialysis. In case of damage to the kidneys, the kidneys are not able to balance minerals like calcium and phosphorus. This causes the parathyroid glands to overproduce PTH which may make bones weak and damage the blood vessels. Cinacalcet assists in reduction of PTH level, thereby securing bones, decreasing bone pains, and averting the long-term problems such as fractures and vascular calcification.
Primary Hyperparathyroidism: Cinacalcet is also used in people with primary hyperparathyroidism, a condition where the parathyroid glands themselves produce too much PTH even when kidney function is normal. It is often prescribed when surgery is not possible or when calcium levels remain too high after surgery. By lowering calcium levels in the blood, cinacalcet helps reduce symptoms like fatigue, kidney stones, abdominal pain, and mood changes.
Parathyroid Carcinoma: Cinacalcet is used to control very high calcium levels caused by parathyroid cancer. In these patients, PTH levels can get extremely high, and cinacalcet helps bring calcium back into a safer range.
MECHANISM OF ACTION: HOW CINACALCET WORKS
The human body controls calcium balance using PTH. The parathyroid glands have special receptors called calcium-sensing receptors (CaSR) that detect the amount of calcium in the blood.
Cinacalcet works by:
- Activating the calcium-sensing receptors (CaSR) on the parathyroid glands.
- This makes the glands “think” there is more calcium in the blood than there actually is.
- As a result, the glands produce less PTH.
- When PTH levels drop, the blood levels of calcium and phosphorus also fall.
This mechanism helps restore a healthier mineral balance. The drug does not cure hyperparathyroidism, but it controls the condition as long as the patient keeps taking it.
DRUG INTERACTIONS OF CINACALCET
Medicines that Affect Your Heart Rhythm: Cinacalcet can affect a part of your heartbeat called the "QT interval." Taking it with other drugs that also affect this can increase the risk of a serious abnormal heart rhythm.
Medicines Processed by the Liver: Cinacalcet is broken down by specific pathways in the liver. It can interact with other drugs that use the same pathways.
Ketoconazole, Itraconazole (Antifungals): These will elevate the amount of cinacalcet in your blood, which increases the risk of side effects.
Dextromethorphan (cough syrup): Cinacalcet may elevate the concentration of this medication, and it may cause such side effects as dizziness or drowsiness.
Being very specific about the medicines you are taking, including over-the-counter drugs and supplements, is essential to inform your doctor about it.
COMMON SIDE EFFECTS AND WARNINGS
Low Blood Calcium: Sometimes the level of calcium can be too low because the intake of cinacalcet lowers PTH and calcium. The symptoms can include the cramps in the muscles, the numbing or tingling and serious cases can also be accompanied by the seizures. The level of calcium will also be followed up and you would be probably put on calcium and Vitamin D supplements.
Nausea and Vomiting: This is extremely frequent particularly at first taking the medication. This may be reduced by taking cinacalcet with food or at the largest meal of the day.
Other Side Effects: There are people who can develop diarrhoea, muscle pains, or weakness.
CONCLUSION
In summary, cinacalcet is a useful medicine that works by tricking the parathyroid glands into lowering a hormone (PTH) that controls calcium. It is vital for patients with kidney disease on dialysis and those with certain parathyroid conditions. Because it can cause low calcium and interact with other drugs, it requires careful monitoring by a doctor.
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