Drug interactions
Itraconazole + Ribociclib
Severity: Major
Itraconazole 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
Itraconazole increases ribociclib exposure, and both drugs prolong the QT interval. This increases the risk of torsades de pointes and myelosuppression.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Ribociclib belongs to Oncology.
Why it happens
Strong CYP3A4 inhibition reduces ribociclib clearance, with additive QT prolongation.
What to do
Avoid the combination and choose an alternative antifungal. If unavoidable, reduce the ribociclib dose per labeling and monitor ECG, electrolytes and blood counts.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole with Ribociclib?
MediHelp rates the interaction as major. Itraconazole 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. Itraconazole increases ribociclib exposure, and both drugs prolong the QT interval. This increases the risk of torsades de pointes and myelosuppression.
How serious is the interaction between Itraconazole 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 an alternative antifungal. If unavoidable, reduce the ribociclib dose per labeling and monitor ECG, electrolytes and blood counts.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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