Drug interactions
Donepezil + Ribociclib
Severity: Major
Donepezil and Ribociclib: major interaction.
Last updated Sources: UK SmPC
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
Ribociclib causes dose-dependent QT prolongation, and donepezil can add to this effect. Ribociclib also inhibits CYP3A4, which may raise donepezil concentrations and further increase cardiac and cholinergic adverse effects.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by ribociclib reducing donepezil metabolism.
What to do
Avoid the combination if possible; if needed, monitor ECG at baseline and during early cycles and keep electrolytes normal. Watch for bradycardia and cholinergic adverse effects of donepezil.
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
- Apozyl 10 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: other medicinal products known to prolong the QTc interval; "Caution is advised when donepezil is used in combination with other medicinal products known to prolong the QTc interval and clinical monitoring(ECG) may be req… — electronic medicines compendium (UK SmPC)
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
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 Donepezil with Ribociclib?
MediHelp rates the interaction as major. Donepezil 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. Ribociclib causes dose-dependent QT prolongation, and donepezil can add to this effect. Ribociclib also inhibits CYP3A4, which may raise donepezil concentrations and further increase cardiac and cholinergic adverse effects.
How serious is the interaction between Donepezil 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 if possible; if needed, monitor ECG at baseline and during early cycles and keep electrolytes normal. Watch for bradycardia and cholinergic adverse effects of donepezil.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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