vilanterol as compared to short-acting beta-agonists. Ribociclib is also a moderate CYP3A4 inhibitor and vilanterol is a CYP3A4 substrate. (Minor) Use caution if coadministration of ribociclib with fluticasone is necessary, as the systemic exposure of fluticasone may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and fluticasone is a CYP3A4 substrate. Although given by topical or inhalation routes, fluticasone may be systemically absorbed resulting in a potential for increased systemic exposure.
Fluvoxamine: (Major) Avoid coadministration of ribociclib with fluvoxamine, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation); consider an alternative treatment with less potential for CYP3A inhibition. If concomitant use is unavoidable, reduce the dose of ribociclib to 400 mg once daily; if fluvoxamine is discontinued, the original dose of ribociclib may be resumed after at least 5 half-lives of fluvoxamine. Ribociclib is extensively metabolized by CYP3A4 and fluvoxamine is a strong CYP3A4 inhibitor.
Formoterol: (Moderate) Due to a possible risk for QT prolongation, ribociclib and long-acting beta-agonists should be used together cautiously. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval like ribociclib. This risk may be more clinically significant with long-acting beta-agonists such as formoterol as compared to short-acting beta-agonists.
Formoterol; Mometasone: (Moderate) Due to a possible risk for QT prolongation, ribociclib and long-acting beta-agonists should be used together cautiously. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval like ribociclib. This risk may be more clinically significant with long-acting beta-agonists such as formoterol as compared to short-acting beta-agonists.
Fosamprenavir: (Severe) Coadministration of ribociclib with fosamprenavir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to fosamprenavir may also increase. Ribociclib is extensively metabolized by CYP3A4. Amprenavir, the active metabolite of fosamprenavir, is a strong CYP3A4 inhibitor that also has the potential to induce CYP3A4; exposure to ribociclib may be increased. Additionally, ribociclib is a moderate CYP3A4 inhibitor and fosamprenavir is a CYP3A4 substrate.
Foscarnet: (Major) Avoid coadministration of ribociclib with foscarnet 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. Both QT prolongation and TdP have been reported during postmarketing use of foscarnet. Concomitant use may increase the risk for QT prolongation.
Fosphenytoin: (Major) Avoid coadministration of ribociclib with fosphenytoin (which is metabolized to phenytoin), as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy; consider an alternative treatment with less potential to induce CYP3A. Ribociclib is e |
