North East and North Cumbria
ICS Formulary
 
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9 Nutrition and blood
09-05-01-02 Hypercalcaemia and hypercalciuria

Zoledronic Acid Zometa®
First Choice
  • 4mg injection
    For hypercalcaemia of malignancy and the prevention of skeletal events in patients with metastatic breast cancer. Prescribe by brand name (Zometa®) to avoid confusion with a different strength product used to treat osteoporosis and Paget’s disease

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Cinacalcet
Formulary

  • Approved for the treatment of secondary hyperparathyroidism in patients with end stage renal disease on maintenance haemodialysis where parathyroid gland surgery has failed or is inappropriate. Red Traffic Light

  • Also for short term use to control symptoms prior to a second attempt at more definitive surgery. Red Traffic Light

  • Approved for patients with primary hyperparathyroidism for whom parathyroidectomy would be indicated based on serum calcium levels, symptoms and end organ damage, but in whom parathyroidectomy is either not clinically appropriate or is contraindicated. It is not normally commissioned if serum calcium concentration is <2.85mmol/L Amber

Link  County Durham and Tees Valley Shared Care Protocol: Cinacalcet
Link  North of Tyne, Gateshead and North Cumbria Cinacalcet Shared Care Guidance
Link  South Tyneside and Sunderland - Cinacalcet Shared Care Guidance
Link  NICE TA117: Hyperparathyroidism - cinacalcet

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Disodium Pamidronate
Formulary
  • 30mg injection

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Etelcalcetide Parsabiv®
Formulary
  • 2.5mg/0.5ml, 5mg/1ml & 10mg/2ml solution for injection
  • Approved for the treatment of secondary hyperparathyroidism in line with NICE and NHS England Commissioning Policy
Link  NICE TA448 Etelcalcetide for treating secondary hyperparathyroidism

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Paricalcitol
Formulary
  • Approved for use in patients with PTH levels < 800mcg/l but  whose treatment with alfacalcidol is restricted due to a high calcium level.

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Calcitonin Salmon®
Formulary
  • 400 units in 2ml injection

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Sodium Clodronate
Formulary

  • 520mg & 800mg tablets


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