rease in treatment-related adverse reactions including hypotension and edema. Exposure to ribociclib may also increase, increasing ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4. Amlodipine is a CYP3A4 substrate and a weak CYP3A4 inhibitor.
Perphenazine: (Minor) Perphenazine is associated with a possible risk for QT prolongation. Theoretically, perphenazine may increase the risk of QT prolongation if coadministered with other drugs that have a risk of QT prolongation, such as ribociclib.
Perphenazine; Amitriptyline: (Major) Avoid coadministration of ribociclib with amitriptyline due to an increased risk for QT prolongation. Systemic exposure of amitriptyline may also be increased resulting in an increase in amitriptyline-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 amitriptyline is a CYP3A4 substrate. (Minor) Perphenazine is associated with a possible risk for QT prolongation. Theoretically, perphenazine may increase the risk of QT prolongation if coadministered with other drugs that have a risk of QT prolongation, such as ribociclib.
Phenobarbital: (Major) Avoid coadministration of ribociclib with phenobarbital, 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 extensively metabolized by CYP3A4 and phenobarbital is a strong CYP3A4 inducer.
Phentermine; Topiramate: (Moderate) Use caution if coadministration of ribociclib with topiramate is necessary, as the systemic exposure of ribociclib may decrease resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and topiramate is a weak CYP3A4 inducer.
Phenylephrine; Promethazine: (Major) Avoid coadministration of ribociclib with promethazine due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Promethazine, a phenothiazine, is associated with a possible risk for QT prolongation. Concomitant use may increase the risk for QT prolongation.
Phenytoin: (Major) Avoid coadministration of ribociclib with 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 extensively metabolized by CYP3A4 and phenytoin is a strong CYP3A4 inducer.
Pimavanserin: (Major) Avoid coadministration of ribociclib with pimavanserin due to an increased risk for QT prolongation. Systemic exposure of pimavanserin 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. Pimavanserin has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and pimavanserin is a CYP3A4 substrate.
Pimozide: ( |
