ion of ribociclib with ondansetron due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of ondansetron may also be increased resulting in an increase in ondansetron-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Ondansetron has been associated with a dose-related increase in the QT interval and postmarketing reports of TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and ondansetron is a CYP3A4 substrate.
Oritavancin: (Moderate) Use caution if coadministration of ribociclib with oritavancin is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and oritavancin is a weak CYP3A4 inducer.
Osimertinib: (Major) Avoid coadministration of ribociclib with osimertinib due to the risk of QT prolongation and torsade de pointes (TdP). Concentration-dependent QTc prolongation has been suggested at the recommended dosing of osimertinib in a pharmacokinetic/pharmacodynamic analysis. Ribociclib has also been shown to prolong the QT interval in a concentration-dependent manner; these ECG changes occurred within the first four weeks of treatment and were reversible with dose interruption. Concomitant use may increase the risk of QT prolongation.
Oxaliplatin: (Major) Avoid coadministration of ribociclib with oxaliplatin 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. QT prolongation and ventricular arrhythmias including fatal TdP have been reported with oxaliplatin use in postmarketing experience. Concomitant use may increase the risk for QT prolongation.
Oxcarbazepine: (Moderate) Use caution if coadministration of ribociclib with oxcarbazepine is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and oxcarbazepine is a moderate CYP3A4 inducer.
Oxybutynin: (Minor) Use caution if coadministration of ribociclib with oxybutynin is necessary, as the systemic exposure of oxybutynin may be increased resulting in increase in treatment-related adverse reactions; the clinical relevance of this interaction is unknown. Ribociclib is a moderate CYP3A4 inhibitor and oxybutynin is a CYP3A4 substrate.
Oxycodone: (Moderate) Use caution if coadministration of ribociclib with oxycodone is necessary, as the systemic exposure of oxycodone may be increased resulting in increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of oxycodone if necessary. Ribociclib is a moderate CYP3A4 inhibitor and oxycodone is a CYP3A4 substrate.
Paclitaxel: (Moderate) Use caution if coadministration of ribociclib with paclitaxel is necessary, as the systemic exposure of paclitaxel may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor. Paclitaxel is a substrate of CYP2C8 and CYP3A4.
Paliperidone: (Major) Avoid coadministration of ribociclib with paliperidone due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Paliperidone has also been associated with QT prolongation. Concomitant us |
