blastine: (Moderate) Use caution if ribociclib is coadministered with vinblastine, as the systemic exposure of vinblastine may increase resulting in vinblastine-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and vinblastine is a CYP3A4 substrate.
Vincristine Liposomal: (Moderate) Use caution if coadministration of ribociclib with vincristine is necessary, as the systemic exposure of vincristine may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and vincristine is a CYP3A4 substrate; formal drug interaction studies have not been conducted with liposomal vincristine, but it is expected to interact with drugs known to interact with non-liposomal vincristine. Concurrent administration of vincristine sulfate with a strong CYP3A4 inhibitor caused an earlier onset and/or an increased severity of neuromuscular side effects.
Vincristine: (Moderate) Use caution if coadministration of ribociclib with vincristine is necessary, as the systemic exposure of vincristine may be increased resulting in an increase in treatment-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and vincristine is a CYP3A4 substrate; formal drug interaction studies have not been conducted with liposomal vincristine, but it is expected to interact with drugs known to interact with non-liposomal vincristine. Concurrent administration of vincristine sulfate with a strong CYP3A4 inhibitor caused an earlier onset and/or an increased severity of neuromuscular side effects.
Vinorelbine: (Major) Use caution if coadministration of ribociclib with vinorelbine is necessary, as the systemic exposure of vinorelbine may be increased resulting in an increase in treatment-related adverse reactions; adjust the dose of vinorelbine if necessary. Ribociclib is a moderate CYP3A4 inhibitor and vinorelbine is a CYP3A4 substrate.
Voriconazole: (Major) Avoid coadministration of ribociclib with voriconazole 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 voriconazole is discontinued, resume the previous ribociclib dose after at least 5 half-lives of voriconazole. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Voriconazole has also been associated with QT prolongation and rare cases of TdP. Concomitant use may increase the risk for QT prolongation. Ribociclib is also extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor; voriconazole is a strong CYP3A4 inhibitor and CYP3A4 substrate.
Vorinostat: (Major) Avoid coadministration of ribociclib with vorinostat due to an increased risk for QT prolongation. Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Vorinostat has also been associated with QT prolongation. Concomitant use may increase the risk for QT prolongation.
Warfarin: (Moderate) Use caution if coadministration of ribociclib with warfarin is necessary, as the systemic exposure of warfarin may be increased resulting in increase in treatment-related adverse reactions; monitor the PT/INR and adjust the dose of warfarin if necessary. Ribociclib is a moderate CYP3A4 inhibitor. The p |
