Drug interactions
Enzalutamide + Ribociclib
Severity: Major
Enzalutamide and Ribociclib: major interaction.
Last updated Sources: EMA 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
Enzalutamide, a strong CYP3A4 inducer, lowers ribociclib exposure and may reduce its efficacy. Ribociclib, a CYP3A4 inhibitor, may in turn modestly raise enzalutamide levels. The combined effect is unpredictable.
What this interaction means in plain words
Enzalutamide 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.
Enzalutamide belongs to Endocrine; Ribociclib belongs to Oncology.
Why it happens
Enzalutamide induces CYP3A4 and increases ribociclib clearance, while ribociclib weakly inhibits CYP3A4.
What to do
Avoid the combination as labeling advises against strong CYP3A inducers with ribociclib. Choose an alternative therapy.
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 Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
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 Enzalutamide with Ribociclib?
MediHelp rates the interaction as major. Enzalutamide 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. Enzalutamide, a strong CYP3A4 inducer, lowers ribociclib exposure and may reduce its efficacy. Ribociclib, a CYP3A4 inhibitor, may in turn modestly raise enzalutamide levels. The combined effect is unpredictable.
How serious is the interaction between Enzalutamide 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 as labeling advises against strong CYP3A inducers with ribociclib. Choose an alternative therapy.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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