C of tasimelteon by approximately 50%.
Telavancin: (Major) Avoid coadministration of ribociclib with telavancin due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Telavancin has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation.
Telithromycin: (Major) Avoid coadministration of ribociclib with telithromycin due to an increased risk for QT prolongation and torsade de pointes (TdP). Additionally, the systemic exposure of both drugs may be increased resulting in an increase in treatment-related adverse reactions (e.g., neutropenia, QT prolongation). If coadministration cannot be avoided, reduce the ribociclib dose to 400 mg once daily. If telithromycin is discontinued, resume the previous ribociclib dose after at least 5 half-lives of telithromycin. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Telithromycin has also been associated with QT prolongation and TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; telithromycin is a strong CYP3A4 inhibitor and CYP3A4 substrate.
Telotristat Ethyl: (Moderate) Use caution if coadministration of ribociclib with telotristat is necessary, as the systemic exposure of ribociclib may be decreased resulting in decreased efficacy. Ribociclib is extensively metabolized by CYP3A4 and telotristat is a CYP3A4 inducer.
Temsirolimus: (Moderate) Use caution if coadministration of ribociclib with temsirolimus is necessary, as the systemic exposure of temsirolimus may be increased resulting in increase in treatment-related adverse reactions; adjust the dose of temsirolimus if necessary. Ribociclib is a moderate CYP3A4 inhibitor. Temsirolimus is primarily metabolized by CYP3A4 to the active metabolite, sirolimus, along with 4 other metabolites. Administration with a strong CYP3A4 inhibitor did not significantly affect the temsirolimus Cmax or AUC; however, the AUC and Cmax of sirolimus increased significantly.
Teniposide: (Moderate) Use caution if ribociclib is coadministered with teniposide, as the systemic exposure of teniposide may be increased resulting in teniposide-related adverse reactions such as enhanced myelosuppression. Ribociclib is a moderate CYP3A4 inhibitor, and teniposide is a CYP3A4 substrate.
Terbinafine: (Moderate) Due to the risk for terbinafine related adverse effects, caution is advised when coadministering ribociclib. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may increase the systemic exposure of terbinafine. Predictions about the interaction can be made based on the metabolic pathways of both drugs. Terbinafine is metabolized by at least 7 CYP isoenzymes, with major contributions coming from CYP3A4; ribociclib is a moderate inhibitor of this enzyme. Monitor patients for adverse reactions if these drugs are coadministered.
Terbutaline: (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 |
