inistration of ribociclib with erythromycin due to an increased risk for QT prolongation and torsade de pointes (TdP). 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. Erythromycin is also associated with QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and erythromycin is a moderate CYP3A4 inhibitor. Additionally, ribociclib is a moderate CYP3A4 inhibitor and erythromycin is a CYP3A4 substrate.
Erythromycin; Sulfisoxazole: (Major) Avoid coadministration of ribociclib with erythromycin due to an increased risk for QT prolongation and torsade de pointes (TdP). 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. Erythromycin is also associated with QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and erythromycin is a moderate CYP3A4 inhibitor. Additionally, ribociclib is a moderate CYP3A4 inhibitor and erythromycin is a CYP3A4 substrate.
Escitalopram: (Major) Avoid coadministration of ribociclib with escitalopram due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of escitalopram 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. Escitalopram has also been associated with a risk of QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and escitalopram is a CYP3A4 substrate.
Eslicarbazepine: (Moderate) Use caution if coadministration of ribociclib with eslicarbazepine is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and eslicarbazepine is a CYP3A4 inducer in vitro.
Estazolam: (Moderate) Use caution if coadministration of ribociclib with estazolam is necessary, as the systemic exposure of estazolam may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of estazolam if necessary. Ribociclib is a moderate CYP3A4 inhibitor and estazolam is a CYP3A4 substrate.
Estradiol Cypionate; Medroxyprogesterone: (Moderate) Use caution if coadministration of ribociclib with medroxyprogesterone is necessary, as the systemic exposure of medroxyprogesterone may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor. Medroxyprogesterone is metabolized primarily by hydroxylation via a CYP3A4.
Estrogens: (Severe) Estrogens, including hormonal contraceptives, could interfere competitively with the pharmacologic action of the aromatase inhibitors. The goal of aromatase inhibitor therapy is to decrease circulating estrogen concentrations and inhibit the growth of hormonally-responsive cancers. Estrogen therapy is not recommended during aromatase inh |
