n 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.
Elbasvir; Grazoprevir: (Moderate) Use caution if ribociclib is coadministered with elbasvir, as the systemic exposure of elbasvir may be increased resulting in adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor, and elbasvir is a CYP3A4 substrate. (Moderate) Use caution if ribociclib is coadministered with grazoprevir, as grazoprevir systemic exposure may be increased resulting in an increased risk for adverse events (e.g., hepatotoxicity). Although the risk is lower, ribociclib exposure may also be increased. Ribociclib is a moderate CYP3A4 inhibitor, and grazoprevir is a CYP3A4 substrate. Ribociclib is also extensively metabolized by CYP3A4, and grazoprevir is a weak CYP3A4 inhibitor.
Eletriptan: (Moderate) Use caution if coadministration of ribociclib with eletriptan is necessary, as the systemic exposure of eletriptan may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and eletriptan is a CYP3A4 substrate. One clinical study demonstrated about a 2-fold increase in Cmax and about a 4-fold increase in AUC when a moderate CYP3A4 inhibitor was coadministered with eletriptan.
Eliglustat: (Major) Avoid coadministration of ribociclib with eliglustat due to an increased risk for QT prolongation. Systemic exposure of eliglustat may also be increased resulting in an increase in treatment-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Eliglustat is predicted to cause PR, QRS, and/or QT prolongation at significantly elevated plasma concentrations. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and eliglustat is a CYP3A4 substrate.
Emtricitabine; Rilpivirine; Tenofovir alafenamide: (Major) Avoid coadministration of ribociclib with rilpivirine due to an increased risk for QT prolongation. Systemic exposure of rilpivirine may also be increased resulting in increase in treatment-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Supratherapeutic doses of rilpivirine (75 to 300 mg per day) have caused QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and rilpivirine is a CYP3A4 substrate.
Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: (Major) Avoid coadministration of ribociclib with rilpivirine due to an increased risk for QT prolongation. Systemic exposure of rilpivirine may also be increased resulting in increase in treatment-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Supratherapeutic doses of rilpivirine (75 to 300 mg per day) have caused QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and rilpivirine is a CYP3A4 substrate.
Enalapril; Felodipine: (Moderate) Use caution if coadministration of ribociclib w |
