necessary, as the systemic exposure of prednisone may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor. Prednisolone, the active metabolite of prednisone, is a CYP3A4 substrate.
Primaquine: (Major) Avoid coadministration of ribociclib with primaquine due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Primaquine has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation.
Primidone: (Major) Avoid coadministration of ribociclib with primidone, 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 primidone is a strong CYP3A4 inducer.
Procainamide: (Major) Avoid coadministration of ribociclib with procainamide 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. Procainamide is also associated with a well-established risk of QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation.
Prochlorperazine: (Minor) Prochlorperazine is associated with a possible risk for QT prolongation. Theoretically, prochlorperazine may increase the risk of QT prolongation if coadministered with other drugs that have a risk of QT prolongation, such as ribociclib.
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.
Propafenone: (Major) Avoid coadministration of ribociclib with propafenone due to an increased risk for QT prolongation. Systemic exposure of propafenone may also be increased resulting in an increase in treatment-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Propafenone is a Class IC antiarrhythmic that increases the QT interval, but largely due to prolongation of the QRS interval. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and propafenone is a CYP3A4 substrate.
Protriptyline: (Major) Avoid coadministration of ribociclib with protriptyline due to an increased risk for QT prolongation. 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.
Quazepam: (Moderate) Use caution if coadministration of ribociclib with quazepam is necessary, as the systemic exposure of quazepam may be increased resulting in increase in treatment-related adverse reactions; adjust the dose of quazepam if necessary. Ribociclib is a moderate CYP3A4 inhibitor and quazepam is a CYP3A4 substrate.
Quetiapine: (Major) Avoid coadministration of ribociclib with quetiapine due to an increased risk for QT pro |
