extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; lapatinib is a weak CYP3A4 inhibitor and CYP3A4 substrate.
Lenvatinib: (Major) Avoid coadministration of ribociclib with lenvatinib due to an increased risk for QT prolongation. Systemic exposure of lenvatinib 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; QT prolongation was also reported during clinical trials of lenvatinib. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and lenvatinib is a CYP3A4 substrate.
Lesinurad: (Moderate) Use caution if ribociclib is coadministered with lesinurad, as exposure to ribociclib may decrease, resulting in reduced efficacy. Ribociclib is extensively metabolized by CYP3A4 and lesinurad is a CYP3A4 inducer.
Leuprolide: (Major) Avoid coadministration of ribociclib with leuprolide due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Androgen deprivation therapy (e.g., leuprolide) prolongs the QT interval; the risk may be increased with the concurrent use of drugs that may prolong the QT interval.
Leuprolide; Norethindrone: (Major) Avoid coadministration of ribociclib with leuprolide due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Androgen deprivation therapy (e.g., leuprolide) prolongs the QT interval; the risk may be increased with the concurrent use of drugs that may prolong the QT interval.
Leva lbuterol: (Minor) Coadministration may result in additive effects on the QT interval. 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 such as ribociclib. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists.
Levofloxacin: (Major) Avoid coadministration of ribociclib with levofloxacin 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. Levofloxacin has also been associated with a risk of QT prolongation and although extremely rare, TdP has been reported during postmarketing surveillance. Concomitant use may increase the risk for QT prolongation.
Levomilnacipran: (Moderate) Use caution if coadministration of ribociclib with levomilnacipran is necessary, as the systemic exposure of levomilnacipran may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and levomilnacipran is a CYP3A4 substrate.
Lidocaine: (Moderate) Use caution if ribociclib is coadministered with lidocaine, as the systemic exposure of lidocaine may increase resulting in lidocaine-related adverse reactions. Adjust the dose of lidocaine if necessary. Ribociclib is a moderate CYP3A4 inhibitor and lidocaine is a CYP3A4 substrate.
Lithium: (Major) Avoid coadministration of ribociclib with lithium due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Lithium has also been associated with QT prolongation. Co |
