-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4 and nicardipine is a CYP3A4 inhibitor.
Nifedipine: (Moderate) Use caution if coadministration of ribociclib with nifedipine is necessary, as the systemic exposure of nifedipine may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and nifedipine is a CYP3A4 substrate.
Nilotinib: (Major) Avoid coadministration of ribociclib with nilotinib due to an increased risk for QT prolongation. 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. Nilotinib has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; nilotinib is a moderate CYP3A4 inhibitor and CYP3A4 substrate.
Nimodipine: (Moderate) Use caution if coadministration of ribociclib with nimodipine is necessary, as the systemic exposure of nimodipine may be increased resulting in increase in treatment-related adverse reactions including hypotension. Ribociclib is a moderate CYP3A4 inhibitor and nimodipine is a CYP3A4 substrate.
Nisoldipine: (Moderate) Use caution if coadministration of ribociclib with nisoldipine is necessary, as the systemic exposure of nisoldipine may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and nisoldipine is a CYP3A4 substrate.
Nortriptyline: (Major) Avoid coadministration of ribociclib with nortriptyline due to an increased risk for QT prolongation. Systemic exposure of nortriptyline 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. Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and nortriptyline is a CYP3A4 substrate.
Octreotide: (Major) Avoid coadministration of ribociclib with octreotide due to an increased risk for QT prolongation and torsade de pointes (TdP). Additionally, the systemic exposure of ribociclib 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. Arrhythmias, sinus bradycardia, and conduction disturbances have occurred during octreotide therapy. Since bradycardia is a risk factor for development of TdP, the potential occurrence of bradycardia during octreotide administration could theoretically increase the risk of TdP in patients receiving drugs that prolong the QT interval. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and octreotide is a moderate CYP3A4 inhibitor.
Ofloxacin: (Major) Avoid coadministration of ribociclib with ofloxacin due to an increased risk for QT prolongati |
