Regpara (Cinacalcet HCl) lowers serum calcium, and therefore patients should be carefully monitored for the occurrence of hypocalcemia. Decreases in serum calcium can also prolong the QT interval, potentially resulting in ventricular arrhythmia. Caution is advised in patients with other risk factors for QT prolongation such as patients with known congenital long QT syndrome or patients receiving drugs known to cause QT prolongation. For patients treated with cinacalcet for chronic kidney disease and receiving dialysis, reduce dose or stop use if low blood calcium, signs of QT prolongation, or arrhythmia continue. For these patients, cinacalcet should not be started if they have severe hypocalcemia.
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