Patient Monitoring and Dose Titration

Appropriate monitoring and titration are key for successful patient management1

Sensipar® with vitamin D and/or phosphate binder1
Sensipar® titration schedule1
Earlier Sensipar® use allows for lower treatment doses3

  • Sensipar® should be titrated no more frequently than every 2 to 4 weeks to target iPTH consistent with the NKF-KDOQI™ recommendation for CKD patients on dialysis of 150-300 pg/mL
  • Sensipar® treatment should not be initiated if serum calcium is less than 8.4 mg/dL
  • Sensipar® should be taken whole and should not be divided1
  • Sensipar® should be taken with food or shortly after a meal1
  • Constant serum drug levels (steady-state) should be achieved within 7 days1

  • At the beginning of therapy and after dose titration, serum calcium and phosphorus levels should be measured within 1 week, and parathyroid hormone (PTH) should be measured within 1 to 4 weeks1
  • Once the maintenance dose has been established, serum calcium and phosphorus should be monitored approximately monthly, and PTH should be monitored every 1 to 3 months1
  • For the most appropriate dosing decisions, PTH levels should be measured at least 12 hours post–Sensipar® dose.1 This recommendation is based on the pharmacodynamics of Sensipar®2
  • Administration of Sensipar® results in a reduction in PTH that nadirs at approximately 2 to 6 hours post–Sensipar® dose, and then returns to predose levels1

    Sensipar® with vitamin D and/or phosphate binders1

    • Sensipar® can be used alone or in combination with vitamin D and/or phosphate binders
    • Sensipar® lowers serum calcium, and therefore patients should be carefully monitored for the occurrence of hypocalcemia
    • Sensipar® treatment should not be initiated if serum calcium is less than the lower limit of the normal range (8.4 mg/dL)
    • Serum calcium should be measured within 1 week after initiation or dose adjustment of Sensipar®. Once the maintenance dose has been established, serum calcium should be measured approximately monthly
    • If serum calcium falls below 8.4 mg/dL but remains above 7.5 mg/dL, or if symptoms of hypocalcemia occur, calcium-containing phosphate binders and/or vitamin D sterols can be used to raise serum calcium
    • If serum calcium falls below 7.5 mg/dL, or if symptoms of hypocalcemia persist and the dose of vitamin D cannot be increased, withhold administration of Sensipar® until serum calcium levels reach 8.0 mg/dL, and/or symptoms of hypocalcemia have resolved. Treatment should be re-initiated using the next-lowest dose of Sensipar®
    • In clinical studies, less than 1% of patients discontinued Sensipar® due to hypocalcemia

    Sensipar® titration schedule1

    The recommended starting oral dose of Sensipar® is 30 mg once daily. Serum calcium and serum phosphorus should be measured within 1 week and PTH should be measured 1 to 4 weeks after initiation or dose adjustment of Sensipar®. Sensipar® should be titrated no more frequently than every 2 to 4 weeks through sequential doses of 60, 90, 120, and 180 mg once daily to target iPTH consistent with the NKF-K/DOQI™ recommendation for chronic kidney disease patients on dialysis of 150 to 300 pg/mL.1 PTH levels should be assessed no earlier than 12 hours after dosing with Sensipar®.1

    Earlier Sensipar® use allows for lower treatment doses3

    *At the end of the efficacy assessment phase.

    Results from combined clinical studies demonstrated that earlier use of Sensipar® requires a lower median dose to achieve PTH goals.3

    Read more about:

    KDOQI™ is a trademark of the National Kidney Foundation, Inc.