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Drug Interactions between ribociclib and Xtandi

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

enzalutamide ribociclib

Applies to: Xtandi (enzalutamide) and ribociclib

GENERALLY AVOID: Coadministration with potent CYP450 3A4 inducers may significantly decrease the plasma concentrations and therapeutic effects of ribociclib, which is a substrate of the isoenzyme. In healthy study subjects, administration of a single 600 mg dose of ribociclib with multiple 600 mg daily doses of rifampin, a potent CYP450 3A4 inducer, resulted in an 81% and 89% decrease in ribociclib peak plasma concentration (Cmax) and systemic exposure (AUC), respectively, compared to ribociclib administered alone. In addition, administration of efavirenz, a moderate CYP450 3A4 inducer, is predicted to decrease ribociclib Cmax and AUC by 37% and 60%, respectively.

MANAGEMENT: Concomitant use of ribociclib with potent CYP450 3A4 inducers should generally be avoided. Alternative agents with no or minimal CYP450 3A4 induction potential are recommended whenever possible. If coadministration is necessary, dosage adjustments as well as clinical and laboratory monitoring should be considered whenever a potent CYP450 3A4 inducer is added to or withdrawn from therapy. Patients should be monitored for therapeutic failure.

References

  1. (2017) "Product Information. Kisqali (ribociclib)." Novartis Pharmaceuticals

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Drug and food interactions

Moderate

ribociclib food

Applies to: ribociclib

GENERALLY AVOID: Pomegranates and grapefruit may increase the systemic exposure to ribociclib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in these fruits. Increased exposure to ribociclib may increase the risk of adverse effects such as infections, neutropenia, leukopenia, anemia, thrombocytopenia, anorexia, nausea, vomiting, diarrhea, stomatitis, alopecia, fatigue, headache, and abnormal liver function may be increased.

MANAGEMENT: Patients receiving ribociclib should avoid consumption of pomegranates or pomegranate juice and grapefruit or grapefruit juice during treatment.

References

  1. (2017) "Product Information. Kisqali (ribociclib)." Novartis Pharmaceuticals

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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