Drug interactions
Cinacalcet + Pitolisant
Severity: Moderate
Cinacalcet and Pitolisant: 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
Pitolisant is metabolized by CYP2D6 and CYP3A4, and cinacalcet strongly inhibits CYP2D6. Pitolisant exposure rises, increasing dose-related adverse effects including insomnia, nausea, anxiety and QT prolongation.
What this interaction means in plain words
Cinacalcet and Pitolisant 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; Pitolisant belongs to Central Nervous System.
Why it happens
Cinacalcet inhibits CYP2D6, decreasing pitolisant clearance.
What to do
Halve the pitolisant dose when cinacalcet is started. In new starts, begin at 8.9 mg daily and do not exceed 17.8 mg daily.
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 Cinacalcet
- Cinacalcet + Etelcalcetide Contraindicated
- Cinacalcet + Eliglustat Major
- Cinacalcet + Metoclopramide Major
- Cinacalcet + Metoclopramide intranasal Major
- Cinacalcet + Tamoxifen Major
- Abiraterone + Cinacalcet Moderate
Other interactions of Pitolisant
- Alfuzosin + Pitolisant Major
- Amiodarone + Pitolisant Major
- Amisulpride + Pitolisant Major
- Anagrelide + Pitolisant Major
- Asenapine + Pitolisant Major
- Bupropion + Pitolisant Major
Frequently asked questions
Can I take Cinacalcet with Pitolisant?
MediHelp rates the interaction as moderate. Cinacalcet and Pitolisant 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. Pitolisant is metabolized by CYP2D6 and CYP3A4, and cinacalcet strongly inhibits CYP2D6. Pitolisant exposure rises, increasing dose-related adverse effects including insomnia, nausea, anxiety and QT prolongation.
How serious is the interaction between Cinacalcet and Pitolisant?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Halve the pitolisant dose when cinacalcet is started. In new starts, begin at 8.9 mg daily and do not exceed 17.8 mg daily.
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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