rimarily 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.
Trandolapril; Verapamil: (Moderate) Use caution if ribociclib is coadministered with verapamil, as the systemic exposure of both ribociclib and verapamil may increase resulting in increased adverse reactions (e.g., hypotension, neutropenia, QT prolongation). Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; Verapamil is both a CYP3A4 substrate and moderate inhibitor.
Trazodone: (Major) Avoid coadministration of ribociclib with trazodone due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of trazodone 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. Trazodone can prolong the QT/QTc interval at therapeutic doses; in addition, there are postmarketing reports of TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and trazodone is a CYP3A4 substrate.
Triazolam: (Moderate) Use caution if coadministration of ribociclib with triazolam is necessary, as the systemic exposure of triazolam may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression. Ribociclib is a moderate CYP3A4 inhibitor and triazolam is a CYP3A4 substrate.
Trifluoperazine: (Minor) Trifluoperazine is associated with a possible risk for QT prolongation. Theoretically, trifluoperazine may increase the risk of QT prolongation if coadministered with other drugs that have a risk of QT prolongation such as ribociclib.
Trimethoprim: (Major) Avoid coadministration of ribociclib with sulfamethoxazole; trimethoprim 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. QT prolongation resulting in ventricular tachycardia and torsade de pointes (TdP) has been reported during postmarketing use of sulfamethoxazole; trimethoprim. Concomitant use may increase the risk for QT prolongation.
Trimipramine: (Major) Avoid coadministration of ribociclib with trimipramine 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.
Triptorelin: (Major) Avoid coadministration of ribociclib with triptorelin due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Androgen deprivation therapy (e.g., triptorelin) prolongs the QT interval; the risk may be increased with the concurrent use of drugs that may prolong the QT interval. Concomitant use may increase the risk for QT prolongation.
Umeclidinium; Vilanterol: (Moderate) Due to a possible risk for QT prolongation, ribociclib and long-acting beta-agonists should be |
