e in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and dextromethorphan is a CYP3A4 substrate.
Acetaminophen; Hydrocodone: (Moderate) Use caution if coadministration of ribociclib with hydrocodone is necessary, as the systemic exposure of hydrocodone may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of hydrocodone if necessary. Ribociclib is a moderate CYP3A4 inhibitor and hydrocodone is a CYP3A4 substrate.
Acetaminophen; 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.
Acetaminophen; Tramadol: (Moderate) Use caution with coadministration of ribociclib and tramadol, as the systemic exposure of tramadol may be increased resulting in an increase in treatment-related adverse reactions including seizures, sedation, and respiratory depression. Ribociclib is a moderate CYP3A4 inhibitor. Tramadol is primarily metabolized by CYP2D6 to an active O-demethylated metabolite (M1) that is critical for its analgesic activity; CYP3A4 is involved in tramadol metabolism to inactive metabolites. Inhibition of CYP3A4 may increase formation of the active metabolite via CYP2D6 metabolism.
Ado-Trastuzumab emtansine: (Moderate) Use caution if coadministration of ribociclib with ado-trastuzumab emtansine is necessary, as the systemic exposure of DM1, the cytotoxic component of ado-trastuzumab emtansine may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor. While no formal drug-drug interaction studies with ado-trastuzumab emtansine have been conducted, in vitro studies indicate that DM1 is metabolized mainly by CYP3A4 and to a lesser extent by CYP3A5.
Albuterol: (Minor) Coadministration may result in additive effects on the QT interval. 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 such as ribociclib. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists.
Albuterol; Ipratropium: (Minor) Coadministration may result in additive effects on the QT interval. 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 such as ribociclib. This risk may be more clinically significant with long-acting beta-agonists as compared to short-acting beta-agonists.
Aldesleukin, IL-2: (Moderate) Use caution if coadministration of ribociclib with aldesleukin is necessary, as the systemic exposure of ribociclib may be increased resulting in an increase in ribociclib-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4; aldesleukin increases IL-6 concentrations, and IL-6 is a 3A4 inhibitor.
Alfentanil: (Moderate) Use caution if coadministration o |
