Cinacalcet

Cinacalcet

Clinical data
Trade names	Sensipar, Mimpara
AHFS/Drugs.com	Monograph
MedlinePlus	a605004
License data	EU EMA: Mimpara US FDA: Cinacalcet
Pregnancy category	AU: B3 US: C (Risk not ruled out)
Routes of administration	By mouth
ATC code	H05BX01 (WHO)
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	20 to 25% increases if taken with food
Protein binding	93 to 97%
Metabolism	Hepatic (CYP3A4-, CYP2D6- and CYP1A2-mediated)
Biological half-life	30 to 40 hours
Excretion	Renal (80%) and fecal (15%)
Identifiers
IUPAC name (R)-N-[1-(1-naphthyl)ethyl]-3- [3-(trifluoromethyl)phenyl]propan-1-amine
CAS Number	226256-56-0 Y
PubChem CID	156419
IUPHAR/BPS	3308
DrugBank	DB01012 Y
ChemSpider	137743 Y
UNII	UAZ6V7728S
KEGG	D03504 Y
ChEBI	CHEBI:48390 Y
ChEMBL	CHEMBL1201284 N
ECHA InfoCard	100.208.116
Chemical and physical data
Formula	C22H22F3N
Molar mass	357.412 g/mol
3D model (Jmol)	Interactive image
SMILES FC(F)(F)c1cccc(c1)CCCN[C@@H](c3c2ccccc2ccc3)C
InChI InChI=1S/C22H22F3N/c1-16(20-13-5-10-18-9-2-3-12-21(18)20)26-14-6-8-17-7-4-11-19(15-17)22(23,24)25/h2-5,7,9-13,15-16,26H,6,8,14H2,1H3/t16-/m1/s1 Y Key:VDHAWDNDOKGFTD-MRXNPFEDSA-N Y
NY (what is this?)

Cinacalcet (INN) is a drug that acts as a calcimimetic (i.e. it mimics the action of calcium on tissues) by allosteric activation of the calcium-sensing receptor that is expressed in various human organ tissues (Van Wagenen et al. (2001), U.S. Pat. 6,211,244). It is sold by Amgen under the trade name Sensipar in North America and Australia and as Mimpara in Europe. Cinacalcet is used to treat secondary hyperparathyroidism (elevated parathyroid hormone levels), a consequence of end-stage renal disease. Cinacalcet is also indicated for the treatment of hypercalcemia in patients with parathyroid carcinoma. Cinacalcet was FDA approved in March 2004, and was the first allosteric G protein-coupled receptor modulator to enter the pharmaceutical market. In 2014, cinacalcet was 76th out of the top 100 drugs in the list of largest selling pharmaceutical products.

Cinacalcet is indicated for the treatment of tertiary hyperparathyroidism in people with chronic kidney disease on dialysis and hypercalcemia in people with parathyroid carcinoma. Cinacalcet can also be used to treat severe hypercalcemia in patients with primary hyperparathyroidism who are unable to undergo parathyroidectomy.

In the treatment of tertiary hyperparathyroidism due to chronic kidney disease on dialysis it does not appear to affect mortality. It does decrease the need for a parathyroidectomy but caused more issues with low blood calcium levels.