Table 2.

Lateral effects of calcimimetic agents and suggested actions to take

Side effect	Frequency	Proposed action
Gastrointestinal events
Nausea	Very common	Give cinacalcet with main meal after dialysis/in the eveningDecrease or fractionate the dose if symptoms appear after a dose increase Caution is advised with anti-emetics, including metoclopramide (QT prolongation)
Vomiting	Very common
Diarrhoea and dyspepsia	Uncommon
Anorexia	Common
Hypocalcaemia and nervous system disorders
Hypocalcaemia	Common	Withhold or reduce cinacalcet until serum calcium levels reach 8 mg/dL or symptoms have resolvedUse of calcium-based phosphate binders, vitamin D sterols or adjustments of dialysis fluid calcium have been suggested by some authors, according to clinical judgement
Dizziness and paraesthesia	Common
Seizures	Uncommon
Others
Skin and cutaneous disorders, rash	Common	Seek other causes; consider discontinuing drug
Musculoskeletal, connective tissue and bone disorders, myalgia	Common	Seek other causes; consider discontinuing drug
Immune system disorders, hypersensitivity reactions	Uncommon	Seek other causes; consider discontinuing drug