Patient leaflet - Cinacalcet Amarox 60 mg film-coated tablets
1. What Cinacalcet is and what it is used for
Cinacalcet works by controlling the levels of parathyroid hormone (PTH), calcium and phosphorous in your body. It is used to treat problems with organs called parathyroid glands. The parathyroids are four small glands in the neck, near the thyroid gland, that produce parathyroid hormone (PTH).
Cinacalcet is used in adults:
to treat secondary hyperparathyroidism in adults with serious kidney disease who
need dialysis to clear their blood of waste products.
to reduce high levels of calcium in the blood (hypercalcaemia) in adult patients with
parathyroid cancer.
to reduce high levels of calcium in the blood (hypercalcaemia) in adult patients with
primary hyperparathyroidism when removal of the gland is not possible.
Cinacalcet is used in children aged 3 years to less than 18 years of age:
to treat secondary hyperparathyroidism in patients with serious kidney disease who
need dialysis to clear their blood of waste products, whose condition is not controlled with other treatments.
In primary and secondary hyperparathyroidism too much PTH is produced by the parathyroid glands. “Primary” means that the hyperparathyroidism is not caused by any other condition and “secondary” means that the hyperparathyroidism is caused by another condition, e.g. kidney disease. Both primary and secondary hyperparathyroidism can cause the loss of calcium in the bones, which can lead to bone pain and fractures, problems with blood and heart vessels, kidney stones, mental illness and coma.
2. What you need to know before you take Cinacalcet
Do not take Cinacalcet
if you are allergic to cinacalcet or any of the other ingredients of this medicine (listed in section 6).
Do not take Cinacalcet
if you have low levels of calcium in your blood. Your doctor will monitor your blood calcium levels.
Warnings and precautions
Talk to your doctor, pharmacist or nurse before taking Cinacalcet.
Before you start taking Cinacalcet, tell your doctor if you have or have ever had:
seizures (fits or convulsions). The risk of having seizures is higher if you have had
them before;
- liver problems;
- heart failure.
Cinacalcet reduces calcium levels. Life threatening events and fatal outcomes associated with low calcium levels (hypocalcaemia) have been reported in adults and children treated with cinacalcet
Please tell your doctor if you experience any of the following which may be signs of low calcium levels: spasms, twitches, or cramps in your muscles, or numbness or tingling in your fingers, toes or around your mouth or seizures, confusion or loss of consciousness while being treated with Cinacalcet.
Low calcium levels can have an effect on your heart rhythm. Tell your doctor if you experience an unusually fast or pounding heartbeat, if you have heart rhythm problems, or if you take medicines known to cause heart rhythm problems, while taking Cinacalcet.
For additional information see section 4.
During treatment with Cinacalcet, tell your doctor:
- if you start or stop smoking, as this may affect the way Cinacalcet works. Children and adolescents
Children under the age of 18 with parathyroid cancer or primary hyperparathyroidism must not take Cinacalcet.
If you are being treated for secondary hyperparathyroidism, your doctor should monitor your calcium levels before starting treatment with Cinacalcet and during treatment with Cinacalcet. You should inform your doctor if you experience any of the signs of low calcium levels as described above.
It is important that you take your dose of Cinacalcet as advised by your doctor.
For children who require doses lower than 30 mg, or who are unable to swallow tablets, other dosage-strengths/pharmaceutical forms of cinacalcet are available.
Other medicines and Cinacalcet
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines particularly etelcalcetide or any other medicines that lower the level of calcium in your blood.
You should not receive Cinacalcet together with etelcalcetide.
Tell your doctor if you are taking the following medicines.
Medicines such as these can affect how Cinacalcet works:
- medicines used to treat skin and fungal infections (ketoconazole, itraconazole and voriconazole);
- medicines used to treat bacterial infections (telithromycin, rifampicin and ciprofloxacin);
- a medicine used to treat HIV infection and AIDS (ritonavir);
- a medicine used to treat depression (fluvoxamine).
Cinacalcet may affect how medicines such as the following work:
- medicines used to treat depression (amitriptyline, desipramine, nortriptyline and clomipramine);
- a medicine used to relieve cough (dextromethorphan);
- medicines used to treat changes in heart rate (flecainide and propafenone);
- a medicine used to treat high blood pressure (metoprolol).
Cinacalcet with food and drink
Cinacalcet should be taken with or shortly after food.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Cinacalcet has not been tested in pregnant women. In case of pregnancy, your doctor may decide to modify your treatment, as Cinacalcet might harm the unborn baby.
It is not known whether Cinacalcet is excreted in human milk. Your doctor will discuss with you if you should discontinue either breast-feeding or treatment with Cinacalcet.
Driving and using machines
Dizziness and seizures have been reported by patients taking Cinacalcet. If you experience these side effects, do not drive or operate machines.
Cinacalcet contains lactose
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3. How to take Cinacalcet
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are unsure. Your doctor will tell you how much Cinacalcet you must take.
Cinacalcet must be taken orally, with or shortly after food. The tablets must be taken whole and are not to be chewed, crushed or divided.
Your doctor will take regular blood samples during treatment to monitor your progress and will adjust your dose if necessary.
UK (Unit-V) Cinacalcet Leaflet
If you are being treated for secondary hyperparathyroidism
The usual starting dose for Cinacalcet in adults is 30 mg (one tablet) once per day.
The usual starting dose of Cinacalcet for children aged 3 years to less than 18 years of age is no more than 0.20 mg/kg of body weight daily.
If you are being treated for parathyroid cancer or primary hyperparathyroidism The usual starting dose for Cinacalcet in adults is 30 mg (one tablet) twice per day.
If you take more Cinacalcet than you should
If you take more Cinacalcet than you should you must contact your doctor immediately. Possible signs of overdose include numbness or tingling around the mouth, muscle aches or cramps and seizures.
If you forget to take Cinacalcet
Do not take a double dose to make up for a forgotten dose.
If you have forgotten a dose of Cinacalcet, you should take your next dose as normal.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Please tell your doctor immediately:
If you start to get numbness or tingling around the mouth, muscle aches or cramps
and seizures. These may be signs that your calcium levels are too low (hypocalcaemia).
If you experience swelling of the face, lips, mouth, tongue or throat which may
cause difficulty in swallowing or breathing (angioedema).
Very common: may affect more than 1 in 10 people
nausea and vomiting, these side effects are normally quite mild and do not last for
long.
Common: may affect up to 1 in 10 people
- dizziness
- numbness or tingling sensation (paraesthesia)
- loss (anorexia) or decrease of appetite
- muscle pain (myalgia)
- weakness (asthenia)
- rash
- reduced testosterone levels
- high potassium levels in the blood (hyperkalaemia)
- allergic reactions (hypersensitivity)
- headache
- seizures (convulsions or fits)
- low blood pressure (hypotension)
- upper respiratory infection
- breathing difficulties (dyspnoea)
- cough
- indigestion (dyspepsia)
- diarrhoea
- abdominal pain, abdominal pain – upper
- constipation
- muscle spasms
- back pain
- low calcium levels in the blood (hypocalcaemia).
Not known: frequency cannot be estimated from available data
- Hives (urticaria)
Swelling of the face, lips, mouth, tongue or throat which may cause difficulty in
swallowing or breathing (angioedema)
Unusually fast or pounding heart beat which may be associated with low levels of
calcium in your blood (QT prolongation and ventricular arrhythmia secondary to hypocalcaemia).
After taking Cinacalcet a very small number of patients with heart failure had worsening of their condition and/or low blood pressure (hypotension). Reporting of side effects
If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Cinacalcet
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date refers to the last day of that month.
Do not use this medicine after the expiry date which is stated on the carton and bottle. The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Cinacalcet contains
The active substance is cinacalcet. Each film-coated tablet contains 30 mg, 60 mg & 90 mg of cinacalcet (as hydrochloride).
The other ingredients are:
Microcrystalline cellulose, pre-gelatinised maize starch, crospovidone, talc, magnesium stearate
The tablets are coated with: Hypromellose, lactose monohydrate, titanium dioxide (E171), triacetin, indigo carmine aluminium lake (E132), iron oxide yellow (E172), macrogol.
What Cinacalcet looks like and contents of the pack
Cinacalcet 30 mg, 60 mg and 90 mg film-coated tablets are light green, oval, biconvex, marked with H on one side of the tablet and C6, C7 or C8 on the other side. 30 mg tablets are approximately 9.9 mm long and 6.2 mm wide.
60 mg tablets are approximately 12.5 mm long and 7.8 mm wide.
90 mg tablets are approximately 14.3 mm long and 8.9 mm wide.
Cinacalcet 30 mg, 60 mg and 90 mg film-coated tablets are available in blister packs of 7, 14, 28, 56 and 84 tablets and perforated unit dose blister packs of 28 x 1, 30 x 1, 84 x 1, 90 x 1 and 100 x 1 tablets
Cinacalcet 30 mg, 60 mg and 90 mg film-coated tablets are available in plastic bottles. Pack sizes of 30 tablets and 90 tablets (3 bottles of 30 tablets).
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Amarox Limited
Congress House, 14 Lyon Road
HA1 2EN Harrow, Middlesex
United Kingdom
Manufacturer
Pharmadox Healthcare Ltd.
KW20A Kordin Industrial Park,
Paola PLA 3000
Malta
Amarox Limited
Congress House, 14 Lyon Road
Harrow, Middlesex HA1 2EN
United Kingdom
Amarox Pharma B.V.
Rouboslaan 32
2252 TR Voorschoten
Netherlands
This medicinal product is authorised in the Member States of the EEA under the following names:
Denmark: Cinacalcet Amarox 30 mg/60 mg/90 mg filmovertrukne tabletter Germany: Cinacalcet Amarox 30 mg/60 mg/90 mg Filmtabletten Netherlands: Cinacalcet Amarox 30 mg/60 mg/90 mg filmomhulde tabletten Spain: Cinacalcet Tarbis 30 mg/60 mg/90 mg comprimidos recubiertos con película E FG
Sweden: Cinacalcet Amarox 30 mg/60 mg/90 mg Filmdragerad tablet United Kingdom: Cinacalcet Amarox 30 mg/60 mg/90 mg film-coated tablets
This leaflet was last revised in 03/2026.
2xxxxxx