Drug interactions
Irinotecan liposomal + Ribociclib
Severity: Moderate
Irinotecan liposomal and Ribociclib: moderate 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
Irinotecan is activated to SN-38 and also inactivated through CYP3A4 oxidation to inactive metabolites. Ribociclib inhibition of CYP3A4 may alter irinotecan and SN-38 exposure and raise the risk of neutropenia and diarrhea, both of which ribociclib can also cause.
What this interaction means in plain words
Irinotecan liposomal and Ribociclib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
CYP3A4 inhibition by ribociclib altering irinotecan disposition, with overlapping myelosuppressive toxicity.
What to do
Monitor blood counts and bowel function closely, and reduce or hold doses for grade 3-4 neutropenia or severe diarrhea.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Irinotecan liposomal with Ribociclib?
MediHelp rates the interaction as moderate. Irinotecan liposomal and Ribociclib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Irinotecan is activated to SN-38 and also inactivated through CYP3A4 oxidation to inactive metabolites. Ribociclib inhibition of CYP3A4 may alter irinotecan and SN-38 exposure and raise the risk of neutropenia and diarrhea, both of which ribociclib can also cause.
How serious is the interaction between Irinotecan liposomal and Ribociclib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and bowel function closely, and reduce or hold doses for grade 3-4 neutropenia or severe diarrhea.
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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