Drug interactions
Fentanyl transdermal + Ribociclib
Severity: Major
Fentanyl transdermal 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
CYP3A4 inhibition by ribociclib can increase and prolong fentanyl exposure from patches, risking serious respiratory depression. The effect can persist because of the skin depot.
What this interaction means in plain words
Fentanyl transdermal 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
Ribociclib inhibits CYP3A4-mediated fentanyl clearance.
What to do
Monitor closely for sedation and respiratory depression and consider a lower fentanyl dose. Continue monitoring after ribociclib is stopped.
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 Fentanyl transdermal with Ribociclib?
MediHelp rates the interaction as major. Fentanyl transdermal 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. CYP3A4 inhibition by ribociclib can increase and prolong fentanyl exposure from patches, risking serious respiratory depression. The effect can persist because of the skin depot.
How serious is the interaction between Fentanyl transdermal 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: Monitor closely for sedation and respiratory depression and consider a lower fentanyl dose. Continue monitoring after ribociclib is stopped.
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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