Drug interactions
Elvitegravir + Ribociclib
Severity: Major
Elvitegravir 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
Elvitegravir is boosted with cobicistat, a strong CYP3A inhibitor, and ribociclib is a CYP3A4 substrate. Exposure to ribociclib rises, increasing QT prolongation and myelosuppression risk. Ribociclib also inhibits CYP3A4, which may modestly raise elvitegravir exposure.
What this interaction means in plain words
Elvitegravir 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
Elvitegravir/cobicistat inhibits CYP3A4 and raises ribociclib levels; ribociclib may in turn reduce elvitegravir clearance via CYP3A4.
What to do
Avoid the combination where possible. If it cannot be avoided, reduce ribociclib dose per labeling 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
Frequently asked questions
Can I take Elvitegravir with Ribociclib?
MediHelp rates the interaction as major. Elvitegravir 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. Elvitegravir is boosted with cobicistat, a strong CYP3A inhibitor, and ribociclib is a CYP3A4 substrate. Exposure to ribociclib rises, increasing QT prolongation and myelosuppression risk. Ribociclib also inhibits CYP3A4, which may modestly raise elvitegravir exposure.
How serious is the interaction between Elvitegravir 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 it cannot be avoided, reduce ribociclib dose per labeling 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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