ritaprevir; Ritonavir: (Severe) Coadministration of ribociclib with ritonavir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to ritonavir may also increase. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Ritonavir has also been associated with QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and ritonavir is a strong CYP3A4 inhibitor; exposure to ribociclib may be increased. Coadministration with ritonavir, a strong CYP3A4 inhibitor increased the ribociclib AUC and Cmax by 3.2-fold and 1.7-fold, respectively, in healthy volunteers. Additionally, ribociclib is a moderate CYP3A4 inhibitor and ritonavir is a CYP3A4 substrate. (Moderate) Use caution if coadministration of ribociclib with paritaprevir is necessary, as the systemic exposure of paritaprevir may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and paritaprevir is a CYP3A4 substrate.
Dasatinib: (Major) Avoid coadministration of ribociclib with dasatinib due to an increased risk for QT prolongation. Additionally, the systemic exposure of both drugs may be increased resulting in an increase in treatment-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. In vitro studies have shown that dasatinib has the potential to prolong the QT interval. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; dasatinib is a weak CYP3A4 inhibitor and CYP3A4 substrate.
Daunorubicin: (Major) Avoid coadministration of ribociclib with daunorubicin due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Acute cardiotoxicity can occur during the administration of daunorubicin; although, the incidence is rare. Acute ECG changes during anthracycline therapy are usually transient and include ST-T wave changes, QT prolongation, and changes in QRS voltage. Concomitant use may increase the risk for QT prolongation.
Deferasirox: (Moderate) Use caution if coadministration of ribociclib with deferasirox is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and deferasirox is a CYP3A4 inducer.
Degarelix: (Major) Avoid coadministration of ribociclib with degarelix due to an increased risk for QT prolongation and torsade de pointes (TdP). Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner; QTc prolongation has also been reported with the use of degarelix. Concomitant use may increase the risk for QT prolongation.
Delavirdine: (Severe) Coadministration of ribociclib with delavirdine is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to delavirdine may also increase. Inhibition of hepatic CYP3A activity by delavirdine is reversible within 1 week after discontinuation. Ribociclib is extensively metabolized by CYP3A4 and delavirdine is a strong CYP3A4 inhibitor; exposure to ribociclib may be increased. Additionally, ribociclib is a moderate CYP3A4 inhibitor and delavirdine is a CYP3A4 substrate.
Desflurane: (Major) Avo |
