diclofenac may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and diclofenac is a CYP3A4 substrate.
Dihydroergotamine: (Major) Use caution if coadministration of ribociclib with dihydroergotamine is necessary, as the systemic exposure of dihydroergotamine may be increased resulting in an increase in dihydroergotamine-related adverse reactions including the risk for vasospasm which can lead to cerebral ischemia and/or ischemia of the extremities; adjust the dose of dihydroergotamine if necessary. Ribociclib is a moderate CYP3A4 inhibitor and dihydroergotamine is a CYP3A4 substrate with a narrow therapeutic window.
Diltiazem: (Moderate) Use caution if coadministration of ribociclib with diltiazem is necessary, as the systemic exposure of diltiazem may be increased resulting in an increase in treatment-related adverse reactions. Exposure to ribociclib may also increase, increasing ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib and diltiazem are moderate inhibitors of CYP3A4 as well as CYP3A4 substrates.
Diphenhydramine; Hydrocodone; Phenylephrine: (Moderate) Use caution if coadministration of ribociclib with hydrocodone is necessary, as the systemic exposure of hydrocodone may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of hydrocodone if necessary. Ribociclib is a moderate CYP3A4 inhibitor and hydrocodone is a CYP3A4 substrate.
Disopyramide: (Major) Avoid coadministration of ribociclib with disopyramide due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of disopyramide may also be increased resulting in an increase in disopyramide-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Disopyramide has also been associated with QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and disopyramide is a CYP3A4 substrate.
Disulfiram: (Moderate) Use caution if coadministration of ribociclib with disulfiram is necessary, as the systemic exposure of disulfiram may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and disulfiram is a CYP3A4 substrate.
Docetaxel: (Moderate) Use caution during coadministration of ribociclib and docetaxel, as the systemic exposure of docetaxel may be increased resulting in increase in treatment-related adverse reactions; adjust the dose of docetaxel if necessary. Ribociclib is a moderate CYP3A4 inhibitor and docetaxel is a CYP3A4 substrate.
Dofetilide: (Severe) Because of the potential for torsade de pointes (TdP), use of ribociclib with dofetilide is contraindicated. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Dofetilide, a Class III antiarrhythmic agent, is associated with a well-established risk of QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation.
Dolasetron: (Major) Avoid coadministration of ribociclib with dolasetron due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Dolasetron has been associated with a dose-dependent prolongation in the QT, PR, and QRS i |
