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Drug Interactions between cholic acid and ribociclib

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

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Interactions between your drugs

Moderate

cholic acid ribociclib

Applies to: cholic acid and ribociclib

GENERALLY AVOID: Coadministration with inhibitors of the bile salt efflux pump (BSEP) may exacerbate accumulation of conjugated bile salts in the liver and lead to clinical symptoms in patients treated with cholic acid.

MANAGEMENT: Concomitant use of cholic acid with drugs that inhibit canalicular membrane bile acid transporters such as the BSEP should generally be avoided. If coadministration is required, close monitoring of serum transaminases and bilirubin is recommended. In addition, serum and urine bile acid levels should be monitored, and the cholic acid dose adjusted accordingly.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2015) "Product Information. Cholbam (cholic acid)." Manchester Pharmaceutical

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

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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