Drug interactions
Cinacalcet + Metoclopramide intranasal
Severity: Major
Cinacalcet and Metoclopramide intranasal: major 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
Cinacalcet is a strong CYP2D6 inhibitor and metoclopramide is cleared substantially by CYP2D6. Higher metoclopramide exposure increases the risk of extrapyramidal effects, tardive dyskinesia, and sedation. The intranasal product has a fixed dose that cannot be reduced.
What this interaction means in plain words
Cinacalcet and Metoclopramide intranasal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of CYP2D6 metabolism of metoclopramide by cinacalcet.
What to do
Avoid the combination with the fixed-dose intranasal product; use an oral metoclopramide form with dose reduction or an alternative antiemetic or prokinetic.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Cinacalcet
- Cinacalcet + Etelcalcetide Contraindicated
- Cinacalcet + Eliglustat Major
- Cinacalcet + Metoclopramide Major
- Cinacalcet + Tamoxifen Major
- Abiraterone + Cinacalcet Moderate
- Amobarbital + Cinacalcet Moderate
Frequently asked questions
Can I take Cinacalcet with Metoclopramide intranasal?
MediHelp rates the interaction as major. Cinacalcet and Metoclopramide intranasal can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cinacalcet is a strong CYP2D6 inhibitor and metoclopramide is cleared substantially by CYP2D6. Higher metoclopramide exposure increases the risk of extrapyramidal effects, tardive dyskinesia, and sedation. The intranasal product has a fixed dose that cannot be reduced.
How serious is the interaction between Cinacalcet and Metoclopramide intranasal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination with the fixed-dose intranasal product; use an oral metoclopramide form with dose reduction or an alternative antiemetic or prokinetic.
What other medicines interact with Cinacalcet?
MediHelp also lists interactions of Cinacalcet with, for example, Etelcalcetide, Eliglustat, Metoclopramide. The full list is on the Cinacalcet page.
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