Can you take Flibanserin with Ribociclib?
1 drug interaction and 15 additional warnings found for the following 2 drugs:
- flibanserin
- ribociclib
Drug interactions
Major drug interactions
Major:
flibanserin ribociclib
Applies to: flibanserin and ribociclib
Using flibanserin together with ribociclib is not recommended.
Combining these medications can significantly increase the blood levels of flibanserin, which may cause excessive drowsiness and decreases in blood pressure that can lead to:
- dizziness
- lightheadedness
- fainting
- accidental injury
You should take flibanserin at bedtime to minimize the risk of these effects.
Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
flibanserin Food/Lifestyle
Applies to: flibanserin
Do not use alcohol too close to the dosing time of flibanserin. Doing so can cause excessive drowsiness and decreases in blood pressure, which may lead to:
- dizziness
- lightheadedness
- fainting
- accidental injury
What to do: Take flibanserin at bedtime to minimize the risk of these effects. It is recommended that you stop drinking alcohol at least two hours before taking flibanserin; otherwise, you should just skip the flibanserin dose that evening. Alcohol should not be consumed until at least the morning after taking flibanserin at bedtime.
Because grapefruit juice can significantly increase the blood levels of flibanserin, you should also avoid the consumption of grapefruit and grapefruit juice during treatment.
Talk to your healthcare provider if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate food/lifestyle interactions
Moderate:
ribociclib Food/Lifestyle
Applies to: ribociclib
Patients should not consume pomegranates, pomegranate juice, grapefruit, or grapefruit juice during treatment with ribociclib unless directed otherwise by your doctor.
Pomegranate juice or grapefruit juice can increase the blood levels of ribociclib.
You may be more likely to experience side effects such as:
- nausea
- vomiting
- diarrhea
- loss of appetite
- abdominal pain
- mouth sores
- hair loss
- weakness
- impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of anemia, bleeding problems, and infections
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
13 potential interactions Applies to: 12 conditions, including High Blood Pressure, Underactive Thyroid, Hypotension, Heart Disease, and Syncope.
Alcoholism
Major:
flibanserin
Flibanserin has a major potential interaction with Alcoholism.
The use of flibanserin is contraindicated along with the ingestion of alcohol, as it increases the risk of hypotension and syncope. It is important to assess the likelihood of the patient abstaining from alcohol, taking into account the current and past drinking behavior.
Dermatitis, Drug-Induced
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Dermatitis, Drug-Induced.
Patients receiving ribociclib have developed severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. This drug must not be reintroduced in patients who have experienced SCARs or other life-threatening cutaneous reactions during ribociclib treatment.
Electrolyte Abnormalities
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Electrolyte Abnormalities.
Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. This drug should be avoided in patients who are at significant risk of developing torsade de pointes, including those with: congenital long QT syndrome; uncontrolled or significant cardiac disease, recent myocardial infarction, heart failure, unstable angina, bradyarrhythmias, uncontrolled hypertension, high degree atrioventricular block, severe aortic stenosis, or uncontrolled hypothyroidism; electrolyte abnormalities. ECG should be performed in all patients prior to initiation of treatment; ribociclib should be started only in patients with QTcF (QT corrected for heart rate using Fridericia's formula) values less than 450 milliseconds. ECG should be repeated at Day 14 of the first cycle, and as clinically indicated. Serum electrolytes (including potassium, calcium, phosphorous, and magnesium) should be monitored before the initiation of treatment, at the beginning of the first 6 cycles, and as clinically indicated; any electrolyte abnormality should be corrected before starting this drug. Ribociclib may require dose interruption, dose reduction, or discontinuation according to observed QT prolongation during therapy.
Heart Disease
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Heart Disease.
Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. This drug should be avoided in patients who are at significant risk of developing torsade de pointes, including those with: congenital long QT syndrome; uncontrolled or significant cardiac disease, recent myocardial infarction, heart failure, unstable angina, bradyarrhythmias, uncontrolled hypertension, high degree atrioventricular block, severe aortic stenosis, or uncontrolled hypothyroidism; electrolyte abnormalities. ECG should be performed in all patients prior to initiation of treatment; ribociclib should be started only in patients with QTcF (QT corrected for heart rate using Fridericia's formula) values less than 450 milliseconds. ECG should be repeated at Day 14 of the first cycle, and as clinically indicated. Serum electrolytes (including potassium, calcium, phosphorous, and magnesium) should be monitored before the initiation of treatment, at the beginning of the first 6 cycles, and as clinically indicated; any electrolyte abnormality should be corrected before starting this drug. Ribociclib may require dose interruption, dose reduction, or discontinuation according to observed QT prolongation during therapy.
High Blood Pressure
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with High Blood Pressure.
Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. This drug should be avoided in patients who are at significant risk of developing torsade de pointes, including those with: congenital long QT syndrome; uncontrolled or significant cardiac disease, recent myocardial infarction, heart failure, unstable angina, bradyarrhythmias, uncontrolled hypertension, high degree atrioventricular block, severe aortic stenosis, or uncontrolled hypothyroidism; electrolyte abnormalities. ECG should be performed in all patients prior to initiation of treatment; ribociclib should be started only in patients with QTcF (QT corrected for heart rate using Fridericia's formula) values less than 450 milliseconds. ECG should be repeated at Day 14 of the first cycle, and as clinically indicated. Serum electrolytes (including potassium, calcium, phosphorous, and magnesium) should be monitored before the initiation of treatment, at the beginning of the first 6 cycles, and as clinically indicated; any electrolyte abnormality should be corrected before starting this drug. Ribociclib may require dose interruption, dose reduction, or discontinuation according to observed QT prolongation during therapy.
Hypotension
Major:
flibanserin
Flibanserin has a major potential interaction with Hypotension.
The use of flibanserin can cause hypotension and syncope. The benefits and risks of therapy should be considered in patients with preexisting conditions that predispose to hypotension. Flibanserin should be used with caution in these patients.
Interstitial Lung Disease
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Interstitial Lung Disease.
Severe, life-threatening, or fatal interstitial lung disease (ILD) and/or pneumonitis can occur in patients treated with ribociclib. Patients should be monitored for pulmonary symptoms indicative of ILD/pneumonitis, which may include hypoxia, cough, and dyspnea. Ribociclib should be interrupted immediately and patients should be evaluated if new or worsening respiratory symptoms suspected to be due to ILD or pneumonitis develop. This drug should be permanently discontinued in patients with any recurrent symptomatic or severe ILD/pneumonitis.
Liver Disease
Major:
flibanserin
Flibanserin has a major potential interaction with Liver Disease.
Flibanserin may accumulate in patients with hepatic impairment. Therapy with flibanserin is contraindicated in patients with compromised hepatic function.
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Liver Disease.
Ribociclib undergoes extensive hepatic metabolism mainly via CYP450 3A4 in humans. Increases in transaminases and drug-induced liver injury have occurred in clinical studies. The starting dose of ribociclib should be reduced to 400 mg in patients with advanced or metastatic breast cancer who have moderate or severe liver dysfunction (Child-Pugh B or C). Liver function tests (LFTs) should be performed before initiating therapy; LFTs should be monitored every 2 weeks for the first 2 cycles, at the beginning of each subsequent 4 cycles, and as clinically indicated. Dose interruption, dose reduction, or drug discontinuation may be necessary based on the severity of transaminase elevations. No dose adjustment is necessary in patients with breast cancer who have mild liver dysfunction (Child-Pugh A).
Pulmonary Impairment
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Pulmonary Impairment.
Severe, life-threatening, or fatal interstitial lung disease (ILD) and/or pneumonitis can occur in patients treated with ribociclib. Patients should be monitored for pulmonary symptoms indicative of ILD/pneumonitis, which may include hypoxia, cough, and dyspnea. Ribociclib should be interrupted immediately and patients should be evaluated if new or worsening respiratory symptoms suspected to be due to ILD or pneumonitis develop. This drug should be permanently discontinued in patients with any recurrent symptomatic or severe ILD/pneumonitis.
Renal Dysfunction
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Renal Dysfunction.
The starting dose of ribociclib should be reduced to 200 mg in patients with severe renal dysfunction. No dose adjustment is necessary in patients with mild or moderate renal dysfunction (estimated GFR 30 to 89 mL/min/1.73 m2).
Syncope
Major:
flibanserin
Flibanserin has a major potential interaction with Syncope.
The use of flibanserin can cause hypotension and syncope. The benefits and risks of therapy should be considered in patients with preexisting conditions that predispose to hypotension. Flibanserin should be used with caution in these patients.
Underactive Thyroid
Moderate:
ribociclib
Ribociclib has a moderate potential interaction with Underactive Thyroid.
Ribociclib has been shown to prolong the QT interval in a concentration-dependent manner. This drug should be avoided in patients who are at significant risk of developing torsade de pointes, including those with: congenital long QT syndrome; uncontrolled or significant cardiac disease, recent myocardial infarction, heart failure, unstable angina, bradyarrhythmias, uncontrolled hypertension, high degree atrioventricular block, severe aortic stenosis, or uncontrolled hypothyroidism; electrolyte abnormalities. ECG should be performed in all patients prior to initiation of treatment; ribociclib should be started only in patients with QTcF (QT corrected for heart rate using Fridericia's formula) values less than 450 milliseconds. ECG should be repeated at Day 14 of the first cycle, and as clinically indicated. Serum electrolytes (including potassium, calcium, phosphorous, and magnesium) should be monitored before the initiation of treatment, at the beginning of the first 6 cycles, and as clinically indicated; any electrolyte abnormality should be corrected before starting this drug. Ribociclib may require dose interruption, dose reduction, or discontinuation according to observed QT prolongation during therapy.
More resources
flibanserin
A total of 517 drugs are known to interact with flibanserin.
- Flibanserin is in the drug class miscellaneous central nervous system agents.
- Flibanserin is used to treat Hypoactive Sexual Desire Disorder.
ribociclib
A total of 785 drugs are known to interact with ribociclib.
- Ribociclib is in the drug class CDK 4/6 inhibitors.
- Ribociclib is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.