Common Registration Assessment, Part 1

Cinacalcet tablet strengths and titration steps for the GPhC assessment

Three original practice questions, with the working shown. Read the stated prescription or plan before calculating.

Published 10 November 2026. Independent revision material, not GPhC questions, not for patient care.

Gloved hands holding a glass dish of white tablets
Photo from Pexels, used under the Pexels licence. It is a stock image and does not show the exercise.

The manufacturer's UK product information for cinacalcet 30 mg film-coated tablets states that for secondary hyperparathyroidism the recommended starting dose for adults is 30 mg once per day, and that the dose should be titrated every 2 to 4 weeks to a maximum dose of 180 mg once daily.

The same information states that titration aims for a target parathyroid hormone (PTH) in dialysis patients of between 150 and 300 pg/ml in the intact PTH assay, that PTH should be measured 1 to 4 weeks after initiation or dose adjustment, and that PTH levels should be assessed at least 12 hours after dosing.

Cinacalcet tablets come in 30 mg, 60 mg and 90 mg strengths, so a stepped dose can be built from one strength or matched to a single larger tablet.

Each question fixes the values needed for its arithmetic. Write the unit beside every step and distinguish the titration step from the maintenance dose. All prescriptions and patients here are fictional; these are revision materials, not for patient care.

The method

  1. Identify the stated week of titration and its stepped dose.
  2. Divide the stated dose by the stated tablet strength for the daily tablet count.
  3. Check the dose against the stated 180 mg once daily maximum.
  4. Keep mg, tablet strengths, weeks and the maximum separate; convert only when the question asks.

Three practice questions

Work each one on paper first, then open the answer. All patients and prescriptions are fictional.

Question 1

A fictional adult starts cinacalcet at the label starting dose, using 30 mg tablets. What is the daily dose, and how many tablets are needed for 28 days?

Show the answer

Answer: 30 mg once daily; 28 tablets

Working: The label starting dose is 30 mg once per day. 1 tablet x 28 days = 28 tablets.

Question 2

A fictional patient starts cinacalcet 30 mg once daily and the dose is stepped up by 30 mg every 4 weeks. What is the daily dose at week 9, and how many 30 mg tablets is that each day?

Show the answer

Answer: 90 mg once daily; 3 tablets

Working: Week 1: 30 mg, week 5: 60 mg, week 9: 90 mg. 90 / 30 = 3 tablets daily.

Question 3

A fictional patient is titrated to the label maximum dose of cinacalcet, using 60 mg tablets. What is the maximum daily dose, and how many tablets is that each day?

Show the answer

Answer: 180 mg once daily; 3 tablets

Working: The label maximum is 180 mg once daily. 180 / 60 = 3 tablets daily.

eMC SmPC: Cinacalcet 30 mg film-coated tablets

https://www.medicines.org.uk/emc/product/11795/smpc

Where marks are lost

  • Stepping the dose weekly; the label titrates every 2 to 4 weeks.
  • Pushing the dose past 180 mg once daily; 180 mg is the label maximum.
  • Adding the 30 mg starting dose to the current step; by week 9 the stepped dose has replaced it, so the daily dose is 90 mg.

Frequently asked questions

Are these official assessment questions?

No. They are original revision exercises, not official GPhC questions and not for patient care.

Does this calculation decide a real cinacalcet dose?

No. Follow the stated prescription in the exercise. Real titration follows PTH and serum calcium results at each step.

How should I check the answer?

Track the current titration step first, then divide the daily mg by the stated tablet strength.

Sources

The questions above are original and use fictional patients and prescriptions. PreRegExamPrep is not affiliated with or endorsed by the General Pharmaceutical Council.

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More calculation topics

See also the formula sheet, the eight sample questions and the approved calculator page.