Drug Interaction Report

Ribociclib may significantly increase the blood levels of entrectinib. This may increase the risk and/or severity of side effects such as dizziness; confusion; hallucinations; problems with concentration, attention, thinking, and memory; mood changes; insomnia; drowsiness; liver problems; increased uric acid levels in the blood (hyperuricemia); congestive heart failure; fluid retention and swelling; changes in electrical activity of the heart (a condition known as QT prolongation, which may lead to irregular heart rhythm that can be life-threatening); vision problems; and low red or white blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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.

Ribociclib may increase the blood levels and effects of letrozole. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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.

Do not consume grapefruit, grapefruit juice, or Seville oranges during treatment with entrectinib. Doing so can significantly increase the blood levels of entrectinib and increase the risk and/or severity of side effects such as dizziness; confusion; hallucinations; problems with concentration, attention, thinking, and memory; mood changes; insomnia; drowsiness; liver problems; increased uric acid levels in the blood (hyperuricemia); congestive heart failure; fluid retention and swelling; changes in electrical activity of the heart (a condition known as QT prolongation, which may lead to irregular heart rhythm that can be life-threatening); vision problems; and low red or white blood cell counts. Talk to your doctor 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.

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.