so extensively metabolized by CYP3A4 and ritonavir is a strong CYP3A4 inhibitor; exposure to ribociclib may be increased. Coadministration with ritonavir, a strong CYP3A4 inhibitor increased the ribociclib AUC and Cmax by 3.2-fold and 1.7-fold, respectively, in healthy volunteers. Additionally, ribociclib is a moderate CYP3A4 inhibitor and ritonavir is a CYP3A4 substrate.
Roflumilast: (Moderate) Use caution if coadministration of ribociclib with roflumilast is necessary, as the systemic exposure of roflumilast may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and roflumilast is a CYP3A4 substrate.
Romidepsin: (Major) Avoid coadministration of ribociclib with romidepsin due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Romidepsin has also been associated with QT prolongation. If romidepsin and ribociclib must be coadministered, appropriate cardiovascular monitoring precautions should be considered, such as the monitoring of electrolytes and ECGs at baseline and periodically during treatment. Systemic exposure of romidepsin may also be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and romidepsin is a CYP3A4 substrate.
Ruxolitinib: (Moderate) Coadministration of ribociclib, a moderate CYP3A4 inhibitor, may increase the exposure to ruxolitinib, a CYP3A4 substrate. Although concurrent use of a moderate CYP3A4 inhibitor is not expected to result in clinically significant increases in ruxolitinib serum concentrations, caution is advised if a moderate CYP3A4 inhibitor is added to a stable dose of ruxolitinib, especially in patients with low platelet counts, as thrombocytopenia is the dose-limiting toxicity of ruxolitinib.
Salmeterol: (Moderate) Due to a possible risk for QT prolongation, ribociclib and long-acting beta-agonists should be used together cautiously. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval like ribociclib. This risk may be more clinically significant with long-acting beta-agonists such as salmeterol as compared to short-acting beta-agonists.
Saquinavir: (Severe) Coadministration of ribociclib with saquinavir is contraindicated, as elevated plasma concentrations of ribociclib may be associated with QT prolongation; exposure to saquinavir may also increase. Both ribociclib and saquinavir prolong the QT interval in a concentration-dependent manner. Ribociclib is also extensively metabolized by CYP3A4 and saquinavir is a strong CYP3A4 inhibitor; exposure to ribociclib may be increased. Additionally, ribociclib is a moderate CYP3A4 inhibitor and saquinavir is a CYP3A4 substrate.
Saxagliptin: (Moderate) Use caution if coadministration of ribociclib with saxagliptin is necessary, as the systemic exposure of saxagliptin may be increased resulting in increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and saxagliptin is a CYP3A4 substrate.
Secobarbital: (Moderate) Use caution if coadministration of ribociclib with secobarbital is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extens |
