n increase in bedaquiline-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Bedaquiline has been reported to prolong the QT interval. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and bedaquiline is a CYP3A4 substrate.
Belladonna Alkaloids; Ergotamine; Phenobarbital: (Major) Avoid coadministration of ribociclib with phenobarbital, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy; consider an alternative treatment with less potential to induce CYP3A. Ribociclib is extensively metabolized by CYP3A4 and phenobarbital is a strong CYP3A4 inducer. (Major) Use caution if coadministration of ribociclib, a moderate CYP3A4 inhibitor, with ergotamine, a CYP3A4 substrate, is necessary, as the systemic exposure of ergotamine may be increased resulting in an increase in ergotamine-related adverse reactions including the risk for vasospasm leading to cerebral ischemia and/or ischemia of the extremities; adjust the dose of ergotamine if necessary.
Bexarotene: (Moderate) Use caution if coadministration of ribociclib with bexarotene is necessary, as the systemic exposure of ribociclib may be decreased, resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and bexarotene is a moderate CYP3A4 inducer.
Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: (Major) Avoid coadministration of ribociclib with metronidazole due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Potential QT prolongation has been reported in limited case reports with metronidazole. Concomitant use may increase the risk for QT prolongation.
Bismuth Subsalicylate; Metronidazole; Tetracycline: (Major) Avoid coadministration of ribociclib with metronidazole due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Potential QT prolongation has been reported in limited case reports with metronidazole. Concomitant use may increase the risk for QT prolongation.
Boceprevir: (Severe) Coadministration of ribociclib with boceprevir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to boceprevir may also increase. Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; boceprevir is a strong CYP3A4 inhibitor and a CYP3A4 substrate.
Bortezomib: (Minor) Use caution if coadministration of ribociclib, a moderate CYP3A4 inhibitor, with bortezomib, a CYP3A4 substrate is necessary. A strong inhibitor increased the exposure of bortezomib by 35%. Moderate inhibitors like ribociclib may also increase the serum concentration of bortezomib, although to a lesser extent. The clinical significance of this interaction is unknown.
Bosentan: (Moderate) Use caution if coadministration of ribociclib with bosentan is necessary, as the systemic exposure of bosentan may be increased resulting in an increase in treatment-related adverse reactions; however, a bosentan dose adjustment is not necessary. Exposure to ribociclib may also decrease, resulting in decreased efficacy. Administration of bosentan with both ribociclib and a strong or moderate CYP2C9 inhibitor is not recommended. Ribociclib is a moderate CYP3A4 inhibitor and sub |
