ion). Ribociclib and isavuconazole are both moderate CYP3A4 inhibitors and CYP3A4 substrates.
Isoflurane: (Major) Avoid coadministration of ribociclib with halogenated anesthetics due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Halogenated anesthetics can also prolong the QT interval. Concomitant use may increase the risk for QT prolongation.
Isoniazid, INH: (Moderate) Use caution if coadministration of ribociclib with isoniazid is necessary, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4 and isoniazid is a moderate CYP3A4 inhibitor.
Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Major) Avoid coadministration of ribociclib with rifampin; the systemic exposure of ribociclib was significantly decreased in a drug interaction study. Consider an alternative treatment with less potential to induce CYP3A. Ribociclib is a CYP3A4 substrate and rifampin is a strong CYP3A4 inducer. In a drug interaction study in healthy volunteers, the ribociclib AUC (0-inf) and Cmax values were decreased by 89% and 81%, respectively, when a single dose of ribociclib 600 mg was administered following 14 days of rifampicin 600 mg daily compared with a single dose of ribociclib administered alone. (Moderate) Use caution if coadministration of ribociclib with isoniazid is necessary, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4 and isoniazid is a moderate CYP3A4 inhibitor.
Isoniazid, INH; Rifampin: (Major) Avoid coadministration of ribociclib with rifampin; the systemic exposure of ribociclib was significantly decreased in a drug interaction study. Consider an alternative treatment with less potential to induce CYP3A. Ribociclib is a CYP3A4 substrate and rifampin is a strong CYP3A4 inducer. In a drug interaction study in healthy volunteers, the ribociclib AUC (0-inf) and Cmax values were decreased by 89% and 81%, respectively, when a single dose of ribociclib 600 mg was administered following 14 days of rifampicin 600 mg daily compared with a single dose of ribociclib administered alone. (Moderate) Use caution if coadministration of ribociclib with isoniazid is necessary, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4 and isoniazid is a moderate CYP3A4 inhibitor.
Isradipine: (Moderate) Use caution if coadministration of ribociclib with isradipine is necessary, as the systemic exposure of isradipine may be increased resulting in an increase in treatment-related adverse reactions including hypotension. Ribociclib is a moderate CYP3A4 inhibitor and isradipine is a CYP3A4 substrate.
Itraconazole: (Major) Avoid coadministration of ribociclib with itraconazole due to the potential for additive effects on the QT interval and significantly increased exposure to ribociclib; exposure to itraconazole may also increase. If coadministration cannot be avoided, reduce the ribociclib dose to 400 mg once daily. If itraconazole is discontinued, resume the previous ribociclib dose after at least 5 half-l |
