longation. Systemic exposure of quetiapine 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. Limited data, including some case reports, suggest that quetiapine may be associated with a significant prolongation of the QTc interval in rare instances. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and quetiapine is a CYP3A4 substrate.
Quinidine: (Major) Avoid coadministration of ribociclib with quinidine due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of quinidine may be increased resulting in an increase in quinidine-related adverse reactions. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Quinidine has also been associated with QT prolongation and torsade de pointes (TdP). Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and quinidine is a CYP3A4 substrate with a narrow therapeutic window.
Quinine: (Major) Avoid coadministration of ribociclib with quinine due to an increased risk for QT prolongation and torsade de pointes (TdP). Additionally, the systemic exposure of both drugs may be affected resulting in an increase in treatment-related adverse reactions (e.g., neutropenia, QT prolongation) or altered efficacy of ribociclib. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Quinine has been associated with QT prolongation and rare cases of TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; quinine is a moderate CYP3A4 inhibitor and inducer as well as a CYP3A4 substrate.
Ramelteon: (Moderate) Use caution if coadministration of ribociclib with ramelteon is necessary, as the systemic exposure of ramelteon may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and ramelteon is a CYP3A4 substrate.
Ranolazine: (Major) Avoid coadministration of ribociclib with ranolazine 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. Ranolazine is associated with dose- and plasma concentration-related increases in the QTc interval. Although there are no studies examining the effects of ranolazine in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; ranolazine is a weak CYP3A4 inhibitor in vitro and CYP3A4 substrate.
Regadenoson: (Major) Avoid coadministration of ribociclib with regadenoson due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Regadenoson has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation.
Regorafenib: (Moderate) Use caution if coadministration of ribociclib with regorafenib is necessary, as the systemic exposure of regorafenib may be increased resulting in incre |
