Drug interactions
Ibrutinib + Ribociclib
Severity: Major
Ibrutinib 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
Ribociclib inhibits CYP3A4 and ibrutinib is extensively metabolized by this enzyme, so ibrutinib exposure rises. This increases risks of bleeding, arrhythmia, cytopenias and other toxicities.
What this interaction means in plain words
Ibrutinib 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.
Ibrutinib belongs to Oncology; Ribociclib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated first-pass and hepatic metabolism of ibrutinib.
What to do
Reduce the ibrutinib dose as per labeling for moderate CYP3A inhibitors and monitor for toxicity, including bleeding and arrhythmia. Resume the usual dose 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
Other interactions of Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Ribociclib?
MediHelp rates the interaction as major. Ibrutinib 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 inhibits CYP3A4 and ibrutinib is extensively metabolized by this enzyme, so ibrutinib exposure rises. This increases risks of bleeding, arrhythmia, cytopenias and other toxicities.
How serious is the interaction between Ibrutinib 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: Reduce the ibrutinib dose as per labeling for moderate CYP3A inhibitors and monitor for toxicity, including bleeding and arrhythmia. Resume the usual dose 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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