Grandma has trouble with Sensipar

[suninclouds]

My grandma has a parathyroid issue. I guess it's with calcium regulation - not really sure, but she has to take Sensipar. She's supposed to take it every day. She started with every 3 days, and was supposed to move up to 1x a day. She's had trouble with it giving her a loss of appetite and just making her feel bad. So, she's been on it several weeks but is still just taking it every 3 days. My mom deals with my grandma's healthcare but she's not asking the right questions - like, "What if she just can't take this medicine every day?" My grandma is 90 so I think much of it may be in her head, but she DOES take a lot of medicines. Her doctor had just said it would be a shame if she didn't take it as prescribed.

Yesterday, my grandma came near to passing out, and went to the hospital. They did bloodwork, did an EKG, but found nothing. The hospital doctor did recommend her not taking the Sensipar as it may be too much for her. She also takes Respiradol (sp?) an anti-psychotic. She has mild dementia. The doctor also said she doesn't need this since she's not psychotic. I'm just baffled that they didn't find anything wrong and that the hospital doctor has such a different opinion as her regular doctor. The regular doctor is actually a specialist and she goes to him for most of her care as she just has a nurse practitioner otherwise (We live in Appalachia - not great medical care + a doctor shortage.). She goes back to regular doctor soon. Anyone who knows about this stuff have any advice? All I know is that when she was faint, her blood pressure was very low. She recently had cataract surgery but was almost 2 weeks ago, and she's recovered well from that. Are there any alternatives to Sensipar? It was either this or another medicine that she didn't tolerate well before and quit taking, but her doctor is adamant about her taking Sensipar.

[Red_Star]

Sensipar works be lessening the amount of parathyroid hormone (PTH) released by the parathyroid gland. Less PTH means less calcium and phosphorus are released from the bones.

Sensipar is prescribed for secondary hyperparathyroidism in patients with chronic kidney disease on dialysis, hypercalcemia in patients with parathyroid carcinoma, and severe hypercalcemia in patients with primary hyperparathyroidism who are unable to undergo parathyroidectomy.

"PTx [parathyroidectomy] can offer elderly patients with PHPT [primary hyperparathyroidism] improved quality of life. PTx is safe and effective in elderly patients, and advanced age alone should not deter surgical referral." - Parathyroid Surgery in the Elderly. Oncologist Journal December 2010 December.

This year a 14 year old died from Senispar (death attributed to severe hypocalcemia). Calcium and magnesium work together to keep the heart pumping (calcium contracts, magnesium relaxes).  There has been cases reported of low blood pressure, worsening heart failure, and/or abnormal heart rhythm (arrhythmia) with impaired heart function taking Sensipar.

There are no listed alternatives for Sensipar other than surgery - depending on the cause - kidney transplant, parathyroidectomy.  Minimal invasive parathyroid surgery takes about 20 minutes.

Risperdal is prescribed for schizophrenia, bipolar affective disorder (manic depression), severe aggressive behaviour in elderly people with Alzheimer's disease, and in intellectually disabled children with conduct disorder. Just to add here, dementia is a possible symptom of primary hyperparathyroidism....

Dementia as presenting symptom of primary hyperparathyroidism: favourable outcome after surgery. Clin Neurol Neurosurg. 2008;110(10):1038–1040.

[Barb135]

The parathyroids control how calcium is used in the body; calcium controls electrical impulses in the body.  If one, or more, of the parathyroids develops a tumor, the only cure is to have it removed.  

Not being familiar with Sensipar, I did a quick google search; I came up with this:

http://www.parathyroid.com/Sensipar-high-calcium.htm

"Sensipar is a drug that can be problematic (dangerous?) when given to patients with PRIMARY hyperparathyroidism. Sensipar (Cinacalcet) is NOT approved by the FDA for treating patients with primary hyperparathyroidism. If your doctor prescribed this drug for you, you should print this page of parathyroid.com and take it to him/her. Sensipar is likely to make you feel sick, and new evidence suggests that Sensipar can make your osteoporosis worse if you take it. Most insurance companies will not pay for this drug for treating primary hyperparathyroidism... and they shouldn't! There is good evidence that taking Sensipar is worse for you than if you took nothing and simply ignored the parathyroid tumor in your neck! The pros and cons of taking Sensipar for primary hyperparathyroidism are discussed on this page. In our opinion, there is almost never a case where a patient with primary hyperparathyroidism should be on this drug! DANGER!   Again, this drug may make you significantly worse and is not approved for patients like you!"

And this:
http://www.rxlist.com/sensipar-drug/patient-images-side-effects.htm

"Call your doctor at once if you have a serious side effect such as:

    numbness or tingly feeling around your mouth, fast or slow heart rate, muscle tightness or contraction, overactive reflexes;
    seizure (convulsions);
    feeling short of breath, even with mild exertion;
    swelling, rapid weight gain; or
    feeling like you might pass out.

Less serious side effects may include:

    nausea, vomiting, diarrhea;
    loss of appetite;
    muscle pain, mild chest pain;
    dizziness; or
    weakness;

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088."