Drug interactions
Artemether / lumefantrine + Ribociclib
Severity: Major
Artemether / lumefantrine and Ribociclib: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both ribociclib and artemether/lumefantrine prolong the QTc interval, raising the risk of torsades de pointes. Ribociclib also inhibits CYP3A4, which may raise artemether and lumefantrine exposure and further increase QT risk.
What this interaction means in plain words
Artemether / lumefantrine and Ribociclib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by ribociclib raising antimalarial concentrations.
What to do
Avoid the combination where possible and consider another antimalarial. If it must be used, check an ECG and electrolytes first and monitor closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Frequently asked questions
Can I take Artemether / lumefantrine with Ribociclib?
MediHelp rates the interaction as major. Artemether / lumefantrine and Ribociclib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both ribociclib and artemether/lumefantrine prolong the QTc interval, raising the risk of torsades de pointes. Ribociclib also inhibits CYP3A4, which may raise artemether and lumefantrine exposure and further increase QT risk.
How serious is the interaction between Artemether / lumefantrine and Ribociclib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and consider another antimalarial. If it must be used, check an ECG and electrolytes first and monitor closely.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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