exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and butalbital is a CYP3A4 inducer. (Moderate) Use caution if coadministration of ribociclib with codeine is necessary, as the systemic exposure of codeine may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of codeine if necessary. Ribociclib is a moderate CYP3A4 inhibitor. Codeine is primarily metabolized by CYP2D6 to morphine, and by CYP3A4 to norocodeine; norcodeine does not have analgesic properties. Concomitant use may result in an increase in codeine plasma concentrations, resulting in greater metabolism by CYP2D6 and increased morphine concentrations.
Aspirin, ASA; Carisoprodol; Codeine: (Moderate) Use caution if coadministration of ribociclib with codeine is necessary, as the systemic exposure of codeine may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of codeine if necessary. Ribociclib is a moderate CYP3A4 inhibitor. Codeine is primarily metabolized by CYP2D6 to morphine, and by CYP3A4 to norocodeine; norcodeine does not have analgesic properties. Concomitant use may result in an increase in codeine plasma concentrations, resulting in greater metabolism by CYP2D6 and increased morphine concentrations.
Aspirin, ASA; Omeprazole: (Minor) Use caution if coadministration of ribociclib with omeprazole is necessary, as the systemic exposure of omeprazole may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and omeprazole is a CYP3A4 substrate.
Aspirin, ASA; Oxycodone: (Moderate) Use caution if coadministration of ribociclib with oxycodone is necessary, as the systemic exposure of oxycodone may be increased resulting in increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of oxycodone if necessary. Ribociclib is a moderate CYP3A4 inhibitor and oxycodone is a CYP3A4 substrate.
Atazanavir: (Severe) Coadministration of ribociclib with atazanavir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to atazanavir may also increase. Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4; atazanavir is a strong CYP3A4 inhibitor and CYP3A4 substrate.
Atazanavir; Cobicistat: (Severe) Coadministration of ribociclib with atazanavir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to atazanavir may also increase. Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4; atazanavir is a strong CYP3A4 inhibitor and CYP3A4 substrate. (Severe) Coadministration of ribociclib with cobicistat is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to cobicistat may also increase. Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; cobicistat is a moderate CYP3A4 inhibitor and CYP3A4 substrate.
Atomoxetine: (Major) Avoid coadministration of ribociclib with atomoxetine due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. QT prolon |
