Drug interactions
Cinacalcet + Ketoconazole
Severity: Moderate
Cinacalcet and Ketoconazole: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketoconazole substantially increases cinacalcet exposure, which may cause hypocalcemia with symptoms such as paresthesia, cramps and QT prolongation.
What this interaction means in plain words
Cinacalcet and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cinacalcet belongs to Miscellaneous; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4, a major metabolic pathway of cinacalcet.
What to do
Monitor serum calcium and parathyroid hormone when starting or stopping ketoconazole. Adjust the cinacalcet dose as needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Cinacalcet
- Cinacalcet + Etelcalcetide Contraindicated
- Cinacalcet + Eliglustat Major
- Cinacalcet + Metoclopramide Major
- Cinacalcet + Metoclopramide intranasal Major
- Cinacalcet + Tamoxifen Major
- Abiraterone + Cinacalcet Moderate
Frequently asked questions
Can I take Cinacalcet with Ketoconazole?
MediHelp rates the interaction as moderate. Cinacalcet and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole substantially increases cinacalcet exposure, which may cause hypocalcemia with symptoms such as paresthesia, cramps and QT prolongation.
How serious is the interaction between Cinacalcet and Ketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum calcium and parathyroid hormone when starting or stopping ketoconazole. Adjust the cinacalcet dose as needed.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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