Drug interactions
Fluoxetine + Ribociclib
Severity: Major
Fluoxetine and Ribociclib: major interaction.
Last updated Sources: US FDA label
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 fluoxetine may add to this effect. Ribociclib is a CYP3A4 inhibitor and fluoxetine is partly metabolized by this enzyme, so fluoxetine levels may rise modestly.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation with ribociclib inhibition of CYP3A4.
What to do
Avoid if possible and choose an antidepressant with lower QT liability. If used, monitor ECG at baseline and during early treatment cycles and keep electrolytes normal.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline 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 Fluoxetine with Ribociclib?
MediHelp rates the interaction as major. Fluoxetine 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 fluoxetine may add to this effect. Ribociclib is a CYP3A4 inhibitor and fluoxetine is partly metabolized by this enzyme, so fluoxetine levels may rise modestly.
How serious is the interaction between Fluoxetine 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 if possible and choose an antidepressant with lower QT liability. If used, monitor ECG at baseline and during early treatment cycles and keep electrolytes normal.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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