Drug Interactions between letrozole / ribociclib and tolvaptan

You should avoid drinking grapefruit juice during treatment with tolvaptan. Grapefruit juice can cause too much of the medication to be in the blood. Serious nervous system side effects such as difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, and coma may occur. 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.

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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; and 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.

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