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Drug interactions

Ivosidenib + Ribociclib

Severity: Major

Ivosidenib 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

Both drugs prolong the QT interval, so combined use raises the risk of torsades de pointes. Ivosidenib is also a CYP3A4 substrate and inducer, which may complicate exposure.

What this interaction means in plain words

Ivosidenib 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.

Ivosidenib belongs to Oncology; Ribociclib belongs to Oncology.

Evidence level: Moderate

Why it happens

Additive QTc prolongation; ivosidenib may also alter CYP3A4-mediated ribociclib exposure.

What to do

Avoid the combination if possible. If necessary, monitor ECG and electrolytes frequently and correct abnormalities.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Ivosidenib with Ribociclib?

MediHelp rates the interaction as major. Ivosidenib 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. Both drugs prolong the QT interval, so combined use raises the risk of torsades de pointes. Ivosidenib is also a CYP3A4 substrate and inducer, which may complicate exposure.

How serious is the interaction between Ivosidenib 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 if possible. If necessary, monitor ECG and electrolytes frequently and correct abnormalities.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

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