Drug interactions
Darunavir + Ribociclib
Severity: Major
Darunavir and Ribociclib: major interaction.
Last updated
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
Darunavir is almost always given with a booster (ritonavir or cobicistat), which strongly inhibits CYP3A4 and raises ribociclib exposure, increasing the risk of QT prolongation and neutropenia. Ribociclib may in turn modestly raise darunavir levels.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Ribociclib belongs to Oncology.
Why it happens
Boosted darunavir inhibits CYP3A4, reducing ribociclib clearance; ribociclib is itself a CYP3A4 inhibitor.
What to do
Avoid if possible and consider an alternative antiretroviral. If it cannot be avoided, reduce the ribociclib starting dose to 400 mg daily and monitor ECG, electrolytes and blood counts.
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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Other interactions of Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Ribociclib?
MediHelp rates the interaction as major. Darunavir 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. Darunavir is almost always given with a booster (ritonavir or cobicistat), which strongly inhibits CYP3A4 and raises ribociclib exposure, increasing the risk of QT prolongation and neutropenia. Ribociclib may in turn modestly raise darunavir levels.
How serious is the interaction between Darunavir 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 if possible and consider an alternative antiretroviral. If it cannot be avoided, reduce the ribociclib starting dose to 400 mg daily and monitor ECG, electrolytes and blood counts.
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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