Drug interactions
Conivaptan + Ribociclib
Severity: Major
Conivaptan and Ribociclib: major interaction.
Last updated Sources: US FDA label
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
Conivaptan is a CYP3A4 substrate and is also a CYP3A4 inhibitor itself. Ribociclib inhibits CYP3A4 and can raise conivaptan concentrations, causing excessive aquaresis and rapid serum sodium rise. Conivaptan labeling contraindicates strong CYP3A inhibitors, and ribociclib adds QT-related concerns.
What this interaction means in plain words
Conivaptan 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
Ribociclib inhibits CYP3A4, reducing conivaptan clearance.
What to do
Avoid the combination where possible. If unavoidable, monitor serum sodium frequently and ECG/QTc and watch for overly rapid sodium correction.
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 Conivaptan with Ribociclib?
MediHelp rates the interaction as major. Conivaptan 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. Conivaptan is a CYP3A4 substrate and is also a CYP3A4 inhibitor itself. Ribociclib inhibits CYP3A4 and can raise conivaptan concentrations, causing excessive aquaresis and rapid serum sodium rise. Conivaptan labeling contraindicates strong CYP3A inhibitors, and ribociclib adds QT-related concerns.
How serious is the interaction between Conivaptan 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. If unavoidable, monitor serum sodium frequently and ECG/QTc and watch for overly rapid sodium correction.
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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