CINACALCET AND MACROLIDES

Ketoconazole raises cinacalcet levels 2-fold and increased the incidence of cinacalcet adverse effects, probably by inhibiting the metabolism of cinacalcet by CYP3A4. Other potent CYP3A4 inhibitors, such as the macrolides, are predicted to interact similarly, although they differ in their ability to inhibit CYP3A4, see macrolides.
It may be prudent to monitor parathyroid hormone and serum calcium more
frequently if a macrolide that potently inhibits CYP3A4 is started or stopped.