Drug interactions
Erythromycin + Ribociclib
Severity: Major
Erythromycin 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
Ribociclib causes dose-dependent QT prolongation, and erythromycin adds to this effect while also raising ribociclib exposure. This increases the risk of torsades de pointes and sudden cardiac events.
What this interaction means in plain words
Erythromycin 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.
Erythromycin belongs to Anti Bacterial; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation, plus erythromycin inhibition of CYP3A4-mediated ribociclib metabolism.
What to do
Avoid the combination and choose a non-macrolide antibiotic. If it cannot be avoided, reduce the ribociclib dose per labeling and monitor ECG and electrolytes.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin 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 Erythromycin with Ribociclib?
MediHelp rates the interaction as major. Erythromycin 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 erythromycin adds to this effect while also raising ribociclib exposure. This increases the risk of torsades de pointes and sudden cardiac events.
How serious is the interaction between Erythromycin 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 and choose a non-macrolide antibiotic. If it cannot be avoided, reduce the ribociclib dose per labeling and monitor ECG and electrolytes.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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