s necessary, as the systemic exposure of amlodipine may be increased resulting in an increase in treatment-related adverse reactions including hypotension and edema. Exposure to ribociclib may also increase, increasing ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4. Amlodipine is a CYP3A4 substrate and a weak CYP3A4 inhibitor.
Amlodipine; Telmisartan: (Moderate) Use caution if coadministration of ribociclib with amlodipine is necessary, as the systemic exposure of amlodipine may be increased resulting in an increase in treatment-related adverse reactions including hypotension and edema. Exposure to ribociclib may also increase, increasing ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4. Amlodipine is a CYP3A4 substrate and a weak CYP3A4 inhibitor.
Amlodipine; Valsartan: (Moderate) Use caution if coadministration of ribociclib with amlodipine is necessary, as the systemic exposure of amlodipine may be increased resulting in an increase in treatment-related adverse reactions including hypotension and edema. Exposure to ribociclib may also increase, increasing ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4. Amlodipine is a CYP3A4 substrate and a weak CYP3A4 inhibitor.
Amobarbital: (Moderate) Use caution if ribociclib is coadministered with amobarbital, as exposure to ribociclib may decrease, resulting in reduced efficacy. Ribociclib is extensively metabolized by CYP3A4 and amobarbital is a CYP3A4 substrate inducer.
Amoxicillin; Clarithromycin; Lansoprazole: (Major) Avoid coadministration of ribociclib with clarithromycin due to the potential for additive effects on the QT interval and significantly increased exposure to ribociclib; exposure to clarithromycin may also increase. If coadministration cannot be avoided, reduce the ribociclib dose to 400 mg once daily. If clarithromycin is discontinued, resume the previous ribociclib dose after at least 5 half-lives of clarithromycin. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Clarithromycin has an established risk for QT prolongation and torsade de pointes (TdP). Concomitant use may increase the risk for QT prolongation. Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; clarithromycin is a strong CYP3A4 inhibitor and CYP3A4 substrate.
Amoxicillin; Clarithromycin; Omeprazole: (Major) Avoid coadministration of ribociclib with clarithromycin due to the potential for additive effects on the QT interval and significantly increased exposure to ribociclib; exposure to clarithromycin may also increase. If coadministration cannot be avoided, reduce the ribociclib dose to 400 mg once daily. If clarithromycin is discontinued, resume the previous ribociclib dose after at least 5 half-lives of clarithromycin. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Clarithromycin has an established risk for QT prolongation and torsade de pointes (TdP). Concomitant use may increase the risk for QT prolongation. Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; clarithromycin is a strong CYP3A4 |
