Ribociclib Interactions
Acetylsalicylic acid
No clinically significant drug interactions identified.
Alendronate
No clinically significant drug interactions identified.
Allopurinol
No clinically significant drug interactions identified.
Alprazolam
Caution - increased level of alprazolam due to 3A4 inhibition. Monitor for signs of toxicity (sedation, lethargy). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Amiodarone
Avoid combination - increased level of amiodarone due to 3A4 inhibiton. Also additive risk of QT prolongation. Choose an alternative agent.
Amitriptyline
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Amlodipine
Caution - increased level of amlodipine due to 3A4 inhibition. Monitor for signs of toxicity (hypotension). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Amoxi/clav
No clinically significant drug interactions identified.
Amoxicillin
No clinically significant drug interactions identified.
Amphetamine / Dextroamphetamine
No clinically significant drug interactions identified.
Apixaban
Caution - increased level of apixaban due to 3A4 inhibition. Monitor for signs of bleeding - dose reduction may be required. Consider choosing an alternative agent.
Aripiprazole
Caution - QT prolongation (EKG monitoring required). Increased level of aripiprazole due to 3A4 inhibition. Monitor for signs of toxicity. If initiating therapy, titrate slowly. If already established on therapy, dose reduction advised. Consider choosing an alternative agent.
Atenolol
Caution - increased level of atenolol due to OCT1/OCT2 inhibition. Monitor for signs of toxicity (hypotension, bradycardia). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Atomoxetine
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Atorvastatin
Caution - increased level of atorvastatin due to 3A4 inhibition. Monitor for signs of toxicity. If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Azithromycin
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Baclofen
No clinically significant drug interactions identified.
Bisoprolol
No clinically significant drug interactions identified.
Buprenorphine/ naloxone
Caution - QT prolongation (EKG monitoring required). Increased level of buprenorphine/naloxone due to 3A4 inhibition. Monitor for signs of toxicity (sedation, confusion, dizziness). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Buproprion
No clinically significant drug interactions identified.
Buspirone
Caution - increased level of buspirone due to 3A4 inhibition. Monitor for signs of toxicity (sedation). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Calcium Carbonate
No clinically significant drug interactions identified.
Canagliflozin
No clinically significant drug interactions identified.
Candesartan
No clinically significant drug interactions identified.
Carbamazepine
Avoid combination - increased level of carbamazepine due to 3A4 inhibition. Decreased level of ribociclib due to 3A4 induction. Choose an alternative agent.
Carvedilol
No clinically significant drug interactions identified.
Celecoxib
No clinically significant drug interactions identified.
Cephalexin
No clinically significant drug interactions identified.
Cetirizine
No clinically significant drug interactions identified.
Chlorthalidone
No clinically significant drug interactions identified.
Cholecalciferol
No clinically significant drug interactions identified.
Ciprofloxacin
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Citalopram
Avoid combination - increased level of citalopram due to 3A4 inhibition. Also additive risk of QT prolongation. Choose an alternative agent.
Clarithromycin
Avoid combination - increased level of both agents due to 3A4 inhibition. Also additive risk of QT prolongation. Choose an alternative agent.
Clindamycin
Caution - increased level of clindamycin due to 3A4 inhibition. Monitor for signs of toxicity (diarrhea). Use the lowest dose and shortest duration clinically indicated. Consider choosing an alternative agent.
Clonazepam
Caution - increased level of clonazepam due to 3A4 inhibition. Monitor for signs of toxicity (sedation, lethargy). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Clonidine
No clinically significant drug interactions identified.
Clopidogrel
No clinically significant drug interactions identified.
Codeine
Caution - increased level of codeine due to 3A4 inhibition. Monitor for signs of toxicity (sedation, confusion, dizziness). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Colchicine (Colcrys)
Caution - increased level of colchicine due to 3A4 inhibition. Dose reduction is required. AVOID use in patients with renal and/or hepatic impairment. AVOID use of extended release colchicine. Monitor for signs of toxicity, including increased bloodwork monitoring. Choose an alternative agent when possible.
Cyclobenzaprine
No clinically significant drug interactions identified.
Dabigatran
No clinically significant drug interactions identified.
Dapagliflozin
No clinically significant drug interactions identified.
Desvenlafaxine
No clinically significant drug interactions identified.
Dexamethasone
Caution - increased level of dexamethasone due to 3A4 inhibition. Monitor for signs of toxicity. If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Dexlansoprazole
No clinically significant drug interactions identified.
Diazepam
Caution - increased level of diazepam due to 3A4 inhibition. Monitor for signs of toxicity (sedation, lethargy). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Diclofenac
No clinically significant drug interactions identified.
Digoxin
No clinically significant drug interactions identified.
Diltiazem
Avoid combination - increased level of both agents due to 3A4 inhibition. Choose an alternative agent.
Dimenhydrinate
No clinically significant drug interactions identified.
Divalproex
No clinically significant drug interactions identified.
Docusate
No clinically significant drug interactions identified.
Domperidone
Avoid combination - increased level of domperidone due to 3A4 inhibiton. Also additive risk of QT prolongation. Choose an alternative agent.
Donepezil
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Doxazosin
No clinically significant drug interactions identified.
Doxycycline
No clinically significant drug interactions identified.
Doxylamine/ Pyridoxine
No clinically significant drug interactions identified.
Duloxetine
No clinically significant drug interactions identified.
Dutasteride
No clinically significant drug interactions identified.
Edoxaban
No clinically significant drug interactions identified.
Eletriptan
Avoid combination - increased level of eletriptan due to 3A4 inhibition. Choose an alternative agent.
Empagliflozin
No clinically significant drug interactions identified.
Enalapril
No clinically significant drug interactions identified.
Escitalopram
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Esomeprazole
No clinically significant drug interactions identified.
Ezetimibe
No clinically significant drug interactions identified.
Famotidine
No clinically significant drug interactions identified.
Fenofibrate
No clinically significant drug interactions identified.
Finasteride
No clinically significant drug interactions identified.
Fluconazole
Caution - QT prolongation (EKG monitoring required). Increased level of ribociclib due to 3A4 inhibition. Use lowest dose and shortest duration as clinically indicated. One-time dose low risk of clinically significant interaction; <1 week course of fluconazole may be considered with increased monitoring; >1 week course of fluconazole not advised. Monitor for signs of ribociclib toxicity. Consider choosing an alternative agent.
Fluoxetine
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Folic Acid
No clinically significant drug interactions identified.
Fosfomycin
No clinically significant drug interactions identified.
Furosemide
No clinically significant drug interactions identified.
Gabapentin
Caution - increased level of gabapentin due to OCT2 inhibition. Monitor for signs of toxicity (sedation, lethargy). If initiating therapy, titrate slowly. If already established on therapy, may require dose reduction. Consider choosing an alternative agent.
Galantamine
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Gliclazide
No clinically significant drug interactions identified.
Glyburide
No clinically significant drug interactions identified.
Guanfacine
Caution - increased level of guanfacine due to 3A4/OCT1/OCT2 inhibition. Monitor for signs of toxicity (hypotension, bradycardia, sedation). If initiating therapy, titrate slowly. If already established on therapy, 50% dose reduction advised. Consider choosing an alternative agent.
Hydralazine
No clinically significant drug interactions identified.
Hydrochlorothiazide
No clinically significant drug interactions identified.
Hydromorphone
No clinically significant drug interactions identified.
Hydroxychloroquine
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Hydroxyzine
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Ibuprofen
No clinically significant drug interactions identified.
Indapamide
No clinically significant drug interactions identified.
Indomethacin
No clinically significant drug interactions identified.
Irbesartan
No clinically significant drug interactions identified.
Isotretinoin
No clinically significant drug interactions identified.
Itraconazole
Avoid combination - increased level of both agents due to 3A4 inhibition. Choose an alternative agent.
Ketorolac
No clinically significant drug interactions identified.
Labetalol
No clinically significant drug interactions identified.
Lansoprazole
No clinically significant drug interactions identified.
Levetiracetam
Caution - QT prolongation (EKG monitoring required). Consider choosing an alternative agent.
Levodopa/carbidopa
No clinically significant drug interactions identified.
Levofloxacin
Avoid combination - additive risk of QT prolongation. Choose an alternative agent.
Levothyroxine
No clinically significant drug interactions identified.
Linagliptin
No clinically significant drug interactions identified.
Liraglutide
No clinically significant drug interactions identified.
