sensipar and Clarithromycin Interactions

Interactions between sensipar(cinacalcet) and Clarithromycin (clarithromycin)

clarithromycin and cinacalcet (Moderate Drug-Drug)

MONITOR: Coadministration with ketoconazole or other potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of cinacalcet, which is partially metabolized by the isoenzyme. According to the product labeling, ketoconazole (200 mg twice a day for 7 days) increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of cinacalcet (90 mg single dose on day 5) by over 2-fold compared to administration of cinacalcet alone.

MANAGEMENT: Pharmacologic response to cinacalcet (i.e., parathyroid hormone and serum calcium levels) should be monitored more closely whenever ketoconazole or other potent inhibitors of CYP450 3A4 (e.g., itraconazole, voriconazole, nefazodone, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics) are added to or withdrawn from therapy, and the cinacalcet dosage adjusted accordingly.