Drug & supplement interaction

American Pawpaw + Cinacalcet

Cinacalcet brand name: Sensipar.

No Known Interaction
The bottom line No known interaction

We found no known interaction between American Pawpaw and Cinacalcet in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Cinacalcet states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

American Pawpaw and Cinacalcet

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Cinacalcet and American Pawpaw in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

American Pawpaw safety at a glance

American Pawpaw overall Use caution The ripe fruit is generally eaten as food, but concentrated leaf, twig, and seed extracts may be toxic and lack good safety data.
Pregnancy Avoid There is not enough safety information, and concentrated extracts may be harmful, so avoid during pregnancy.
Breastfeeding Avoid Safety has not been studied, so avoid concentrated pawpaw supplements while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Cinacalcet and American Pawpaw? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Cinacalcet

Interactions in our licensed database are recorded against drug classes, not just single drug names. Cinacalcet is filed under a single classification — oral drugs. American Pawpaw has documented interactions with 1 drug class — the most serious being antineoplastics (minor) — and none of Cinacalcet’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

American Pawpaw Does Interact With Other Medications

American Pawpaw has 25 minor known drug interactions in our database — Cinacalcet isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against American Pawpaw

Covers the 2,830 medications we’ve checked against American Pawpaw. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests American Pawpaw and Cinacalcet May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Hives Worth acting on Additional detail

    American Pawpaw

    “In general, American pawpaw is well tolerated. However, cases of urticaria, nausea, vomiting, bowel disturbances, headache, and faintness have been reported following ingestion of pawpaw fruit. Similarly, American pawpaw extract may cause vomiting when taken orally or contact dermatitis when applied topically.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 89429. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.
    3. 1525. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.

    “Orally, American pawpaw fruit can cause urticaria.

    Topically, American pawpaw extract can cause contact dermatitis.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in dermatitis.

    2 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 1525. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.

    Cinacalcet

    Listed in the ADVERSE REACTIONS section of the FDA label for Cinacalcet. Read the label on DailyMed ›

  • Vomiting / Nausea reported in 4.9% of FDA reports for Cinacalcet Additional detail

    American Pawpaw

    “Orally, American pawpaw fruit can cause nausea, vomiting, bowel disturbances, and burning of the throat and stomach. American pawpaw extract can cause vomiting when taken orally.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    2 sources cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
    2. 89429. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.

    Cinacalcet

    Listed in the ADVERSE REACTIONS section of the FDA label for Cinacalcet, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • A skin rash Additional detail

    American Pawpaw

    Recorded for American Pawpaw in the same Natural Medicines adverse-effect record shown under Hives above.

    Cinacalcet

    Listed in the ADVERSE REACTIONS section of the FDA label for Cinacalcet. Read the label on DailyMed ›

  • Headache Additional detail

    American Pawpaw

    “Orally, American pawpaw fruit can cause headache and faintness.”

    American Pawpaw · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 89428. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI

    Cinacalcet

    Listed in the ADVERSE REACTIONS section of the FDA label for Cinacalcet. Read the label on DailyMed ›

Effects for Cinacalcet come from the ADVERSE REACTIONS section of its FDA label; effects for American Pawpaw come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 48,763 voluntary FDA FAERS reports for Cinacalcet that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Cinacalcet Products Have a Food Rule — American Pawpaw Should Not Break It

At least one FDA label for a product containing Cinacalcet says to take it with food. If you take American Pawpaw on an empty stomach out of habit, keep them separate — and take Cinacalcet with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Cinacalcet products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Cinacalcet tablets should be taken with food or shortly after a meal ( 2.1 ) • Tablets should always be taken whole and not divided ( 2.1 ) • Secondary HPT in patients with CKD on dialysis ( 2.2 ): o Starting dose is 30 mg once daily.

From the Dosage and Administration section of the FDA label we read for Cinacalcet — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Cinacalcet

This page covers American Pawpaw only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cinacalcet page lists 17 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Coffee Charcoal (moderate), European Mandrake (moderate), Glucomannan (moderate) and Guar Gum (moderate).

By severity: 1 major · 7 moderate · 9 minor.

From our pharmacist’s overview on the Cinacalcet page

“Cinacalcet (Sensipar) is dosed carefully against blood calcium and parathyroid hormone levels, usually in people with kidney disease, so anything that changes how much of a dose actually gets absorbed deserves real attention. All 17 supplement interactions on file share a single mechanism.”

Reviewed by 2 · Jul 18, 2026

Open the Cinacalcet interaction page

How much people look this up

Where American Pawpaw and Cinacalcet Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement American Pawpaw
Top half

#678 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cinacalcet
Top half

#914 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every American Pawpaw reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The American Pawpaw and Cinacalcet records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About American Pawpaw

What is American Pawpaw?

American Pawpaw
  • Anticancer interest
  • Lice and head lice treatment (topical)
  • Traditional digestive remedy
  • General wellness/antioxidant
  • Insecticide (historical seed use)

American pawpaw is a North American fruit tree whose leaves, twigs, and seeds contain compounds called acetogenins that have shown cancer-cell-killing activity in laboratory studies. However, strong human evidence for any health benefit is lacking, and the seeds, bark, and unripe parts can be toxic, so supplements should be used cautiously and only under professional guidance.

Asimina triloba · Annonaceae · Fruit, seeds, bark, leaves, and twigs · Fresh fruit, capsules, extracts, and standardized acetogenin products

An interaction check asks whether these two react with each other — it does not ask whether American Pawpaw is a good idea for someone in your situation. Here is what our American Pawpaw record says about it on its own.

American Pawpaw: dosing

There is no established standardized dose for American pawpaw supplements. Products vary widely in strength and which part of the plant they use, which makes safe dosing hard to determine.If you choose to use a pawpaw product, follow the directions on the label and do not exceed them.

From our American Pawpaw monograph — the full record covers uses, side effects and every documented interaction.

Read the full American Pawpaw monograph & all interactions
Medication

About Cinacalcet

What Is Cinacalcet Used For?

Brand name: Sensipar

Cinacalcet tablets are used to treat secondary hyperparathyroidism (overactive parathyroid glands caused by kidney disease) in adult patients with chronic kidney disease (CKD) who are on dialysis. This use applies to cinacalcet tablets, cinacalcet hydrochloride tablets, and Sensipar. Importantly, cinacalcet is not approved for CKD patients who are not on dialysis, due to a higher risk of dangerously low calcium levels.

Cinacalcet tablets are also used to lower high calcium levels (hypercalcemia) in adults with parathyroid carcinoma (a rare cancer of the parathyroid gland), and in adults with primary hyperparathyroidism who need surgery based on their calcium levels but cannot have that surgery.

Most-Reported Side Effects for Cinacalcet

From FAERS, the FDA’s public side-effect reporting system (48,763 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Hospitalisation 6,957 reports
Laboratory test abnormal 4,226 reports
Nausea 2,405 reports
Vomiting 1,655 reports
Malaise 1,584 reports
See full Cinacalcet drug information
Keep checking

Other Drugs & American Pawpaw

Browse every other medication we’ve checked against American Pawpaw — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
25Minor
2,804No known interaction
Minor

25 interactions

No interaction 2,804 drugs checked — show the list
Evidence & sources

American Pawpaw References

The 4 references that drive our American Pawpaw monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Avalos J, Rupprecht JK, McLaughlin JL, et al. Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba (Annonaceae). Contact Dermatitis 1993;29:33-5.
  2. McCage, C. M., Ward, S. M., Paling, C. A., Fisher, D. A., Flynn, P. J., and McLaughlin, J. L. Development of a paw paw herbal shampoo for the removal of head lice. Phytomedicine 2002;9(8):743-748. PubMed
  3. Barber MA. Poisoning due to the papaw (Asimina triloba). JAMA. 1905;XLV(27):2013-2014. DOI
  4. McLaughlin JL. Paw paw and cancer: Annonaceous acetogenins from discover to commercial products. J Nat Prod. 2008;71:1311-1321.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking American Pawpaw and Cinacalcet Together: Common Questions

Is it safe to take American Pawpaw with Cinacalcet?
We do not list a known interaction between American Pawpaw and Cinacalcet. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do American Pawpaw and Cinacalcet have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take American Pawpaw and Cinacalcet at the same time of day?
At least one FDA label for a product containing Cinacalcet says to take it with food. If you take American Pawpaw on an empty stomach out of habit, keep them separate and take Cinacalcet with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Cinacalcet products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the American Pawpaw and Cinacalcet combination checked?
Interactions in our licensed database are recorded against drug classes. Cinacalcet is filed under 1 classification, and American Pawpaw has documented interactions with 1 drug class — none of Cinacalcet's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does American Pawpaw interact with any other medications?
Yes. American Pawpaw has 25 documented drug interactions in our database — Cinacalcet is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Cinacalcet interact with any supplements?
Yes. Cinacalcet has documented interactions with 17 supplements in our database — American Pawpaw is not one of them. The Cinacalcet interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Cinacalcet and American Pawpaw?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.