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 vilanterol as compared to short-acting beta-agonists. Ribociclib is also a moderate CYP3A4 inhibitor and vilanterol is a CYP3A4 substrate.
Vandetanib: (Major) Avoid coadministration of ribociclib with vandetanib due to an increased risk for QT prolongation and torsade de pointes (TdP). Both drugs have been shown to prolong the QT interval in a concentration-dependent manner. Sudden death and TdP have also been reported in patients receiving vandetanib. Concomitant use may increase the risk for QT prolongation.
Vardenafil: (Major) Avoid coadministration of ribociclib with vardenafil due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of vardenafil 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. Vardenafil is associated with QT prolongation; both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval (e.g., 4 to 6 msec calculated by individual QT correction). Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and vardenafil is a CYP3A4 substrate.
Vemurafenib: (Major) Avoid coadministration of ribociclib with vemurafenib due to an increased risk for QT prolongation. If vemurafenib and ribociclib must be coadministered, ECG monitoring is recommended. Systemic exposure of vemurafenib 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. Vemurafenib has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and vemurafenib is a CYP3A4 substrate.
Venlafaxine: (Major) Avoid coadministration of ribociclib with venlafaxine due to an increased risk for QT prolongation and torsade de pointes (TdP). Systemic exposure of venlafaxine 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. Venlafaxine administration is associated with a possible risk of QT prolongation; TdP has reported with postmarketing use. Concomitant use may increase the risk for QT prolongation. Ribociclib is also a moderate CYP3A4 inhibitor and venlafaxine is a CYP3A4 substrate.
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.
Vilazodone: (Moderate) Use caution if ribociclib is coadministered with vilazodone, as the systemic exposure of vilazodone may increase resulting in vilazodone-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and vilazodone is a CYP3A4 substrate.
Vin |
