pon clinical response. Adults receiving a combination of a CYP3A4 and CYP2D6 inhibitor for more than 14 days should have their Abilify Maintena dose reduced from 400 mg/month to 200 mg/month or from 300 mg/month to 160 mg/month, respectively. There are no dosing recommendations for Aristada during use of a mild to moderate CYP3A4 inhibitor.
Armodafinil: (Moderate) Use caution if coadministration of ribociclib with armodafinil is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and armodafinil is a weak, concentration-dependent CYP3A4 inducer in vitro.
Arsenic Trioxide: (Major) Avoid coadministration of ribociclib with arsenic trioxide due to an increased risk for QT prolongation and torsade de pointes (TdP). If concomitant drug use is unavoidable, frequently monitor electrocardiograms. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Prolongation of the QT interval, TdP, and complete atrioventricular block have been reported with arsenic trioxide use. Concomitant use may increase the risk for QT prolongation.
Artemether; Lumefantrine: (Major) Avoid coadministration of ribociclib with artemether due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of artemether may also be increased resulting in an increase in artemether-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Artemether has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and artemether is a CYP3A4 substrate. (Major) Avoid coadministration of ribociclib with lumefantrine due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of lumefantrine may also be increased resulting in increase in lumefantrine-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Artemether; lumefantrine is also associated with prolongation of the QT interval. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a CYP3A4 inhibitor in vitro at clinically relevant concentrations and lumefantrine is a CYP3A4 substrate. Coadministration with ribociclib at a reduced dose of 400 mg increased the AUC and Cmax of a sensitive CYP3A4 substrate by 3.8-fold and 2.1-fold, respectively, in healthy volunteers; when given at the recommended dose of 600 mg, coadministration with a sensitive CYP3A4 substrate is predicted to increase the AUC and Cmax by 5.2-fold and 2.4-fold, respectively.
Asenapine: (Major) Avoid coadministration of ribociclib with asenapine due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Asenapine has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation.
Aspirin, ASA; Butalbital; Caffeine: (Moderate) Use caution if coadministration of ribociclib with butalbital is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and butalbital is a CYP3A4 inducer.
Aspirin, ASA; Butalbital; Caffeine; Codeine: (Moderate) Use caution if coadministration of ribociclib with butalbital is necessary, as the systemic |
