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Drug Interactions between isavuconazonium and ribociclib

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

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Interactions between your drugs

Moderate

isavuconazonium ribociclib

Applies to: isavuconazonium and ribociclib

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of isavuconazole, which is primarily metabolized by CYP450 3A4 and 3A5 and subsequently by uridine diphosphate glucuronosyltransferases (UGT). When a single dose of isavuconazonium sulfate (equivalent to 200 mg of isavuconazole) was administered to healthy volunteers following multiple dosing of the potent CYP450 3A4 inhibitor ketoconazole (200 mg twice daily for 24 days), isavuconazole peak plasma concentration (Cmax) increased by 9% and systemic exposure (AUC) increased by 422%. Lopinavir-ritonavir (400 mg-100 mg twice daily) increased the Cmax and AUC of isavuconazole by 74% and 96%, respectively.

MANAGEMENT: Caution is advised when isavuconazonium sulfate is prescribed with CYP450 3A4 inhibitors. Patients should be monitored for adverse effects such as nausea, vomiting, diarrhea, peripheral edema, hypokalemia, hypomagnesemia, and hepatotoxicity. In addition, many CYP450 3A4 inhibitors are also substrates of the isoenzyme, thus pharmacologic response to these agents should also be monitored, as isavuconazole itself is reportedly a moderate CYP450 3A4 inhibitor.

References (1)
  1. (2015) "Product Information. Cresemba (isavuconazonium)." Astellas Pharma US, Inc

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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