aliskiren-related adverse reactions. Ribociclib is a moderate CYP3A4 inhibitor and aliskiren is a CYP3A4 substrate.
Alogliptin; Pioglitazone: (Moderate) Coadminister ribociclib and pioglitazone with caution, as the systemic exposure of pioglitazone may be increased resulting in pioglitazone-related adverse reactions; adjust the dose of pioglitazone if necessary. Exposure to ribociclib may also decrease, resulting in reduced efficacy. Ribociclib is extensively metabolized by CYP3A4 and is a moderate CYP3A4 inhibitor in vitro; pioglitazone is a CYP3A4 substrate and inducer.
Alprazolam: (Moderate) Use caution if coadministration of ribociclib with alprazolam is necessary, as the systemic exposure of alprazolam may be increased resulting in an increase in alprazolam-related adverse reactions; adjust the dose of alprazolam if necessary. Ribociclib is a moderate CYP3A4 inhibitor and alprazolam is a CYP3A4 substrate.
Amiodarone: (Major) Avoid coadministration of ribociclib with amiodarone due to an increased risk for QT prolongation and torsade de pointes (TdP). The systemic exposure of both drugs may also increase resulting in an increase in treatment-related adverse reactions (e.g., neutropenia, QT prolongation). Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. Amiodarone, a Class III antiarrhythmic agent, is associated with a well-established risk of QT prolongation and TdP. Although the frequency of TdP is less with amiodarone than with other Class III agents, amiodarone is still associated with a risk of TdP. Due to the extremely long half-life of amiodarone, a drug interaction is possible for days to weeks after discontinuation of amiodarone. Concomitant use may increase the risk for QT prolongation. Ribociclib is a moderate CYP3A4 inhibitor and is extensively metabolized by CYP3A4; amiodarone is a moderate CYP3A4 substrate and moderate inhibitor.
Amitriptyline: (Major) Avoid coadministration of ribociclib with amitriptyline due to an increased risk for QT prolongation. Systemic exposure of amitriptyline may also be increased resulting in an increase in amitriptyline-related adverse reactions. 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. Ribociclib is also a moderate CYP3A4 inhibitor and amitriptyline is a CYP3A4 substrate.
Amitriptyline; Chlordiazepoxide: (Major) Avoid coadministration of ribociclib with amitriptyline due to an increased risk for QT prolongation. Systemic exposure of amitriptyline may also be increased resulting in an increase in amitriptyline-related adverse reactions. 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. Ribociclib is also a moderate CYP3A4 inhibitor and amitriptyline is a CYP3A4 substrate. (Moderate) Use caution if coadministration of ribociclib with chlo |
