increased resulting in an increase in treatment-related adverse reactions (e.g., neutropenia, QT prolongation). Both drugs have been shown to prolong the QT interval in a concentration-dependent manner. Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and dronedarone is a moderate CYP3A4 inhibitor. Additionally, ribociclib is a moderate CYP3A4 inhibitor and dronedarone is a CYP3A4 substrate.
Droperidol: (Major) Avoid coadministration of ribociclib with droperidol 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. Droperidol administration is associated with an established risk for QT prolongation and torsade de pointes (TdP). Concomitant use may increase the risk for QT prolongation.
Drospirenone; Ethinyl Estradiol: (Moderate) Use caution if coadministration of ribociclib with ethinyl estradiol is necessary, as the systemic exposure of ethinyl estradiol may be increased resulting in an increase in estrogenic-related adverse reactions (e.g., nausea, breast tenderness). Ribociclib is a moderate CYP3A4 inhibitor and ethinyl estradiol is a CYP3A4 substrate.
Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) Use caution if coadministration of ribociclib with ethinyl estradiol is necessary, as the systemic exposure of ethinyl estradiol may be increased resulting in an increase in estrogenic-related adverse reactions (e.g., nausea, breast tenderness). Ribociclib is a moderate CYP3A4 inhibitor and ethinyl estradiol is a CYP3A4 substrate.
Dutasteride; Tamsulosin: (Moderate) Use caution if coadministration of ribociclib with tamsulosin is necessary, especially at a tamsulosin dose higher than 0.4 mg, as the systemic exposure of tamsulosin may be increased resulting in increase in treatment-related adverse reactions including hypotension, dizziness, and vertigo. Ribociclib is a moderate CYP3A4 inhibitor and tamsulosin is a CYP3A4 substrate. The effect of concomitant use of a moderate CYP3A4 inhibitor with tamsulosin has not been eva luated; however, administration with a strong CYP3A4 inhibitor significantly increased the AUC and Cmax of tamsulosin.
Efavirenz: (Major) Avoid coadministration of ribociclib with efavirenz due to an increased risk for QT prolongation. Additionally, the systemic exposure of efavirenz may be increased resulting in an increase in treatment-related adverse reactions and the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner; QTc prolongation has also been observed with the use of efavirenz. Concomitant use may increase the risk for QT prolongation. Ribociclib is extensively metabolized by CYP3A4 and efavirenz is a moderate CYP3A4 inducer. Additionally, ribociclib is a moderate CYP3A4 inhibitor and efavirenz is a CYP3A4 substrate.
Efavirenz; Emtricitabine; Tenofovir: (Major) Avoid coadministration of ribociclib with efavirenz due to an increased risk for QT prolongation. Additionally, the systemic exposure of efavirenz may be increased resulting in an increase in treatment-related adverse reactions and the systemic exposure of ribociclib may be decreased resulting i |
