Drug interactions
Cinacalcet + St john's wort
Severity: Moderate
Cinacalcet and St john's wort: 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
St John's wort induces CYP3A4 and may lower cinacalcet exposure. This could reduce efficacy in controlling PTH and calcium.
What this interaction means in plain words
Cinacalcet and St john's wort 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.
Why it happens
Induction of CYP3A4 by hyperforin increases cinacalcet clearance.
What to do
Advise the patient to avoid St John's wort, or monitor serum calcium and PTH and adjust the cinacalcet dose if it is used.
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
Frequently asked questions
Can I take Cinacalcet with St john's wort?
MediHelp rates the interaction as moderate. Cinacalcet and St john's wort 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. St John's wort induces CYP3A4 and may lower cinacalcet exposure. This could reduce efficacy in controlling PTH and calcium.
How serious is the interaction between Cinacalcet and St john's wort?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise the patient to avoid St John's wort, or monitor serum calcium and PTH and adjust the cinacalcet dose if it is used.
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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