Drug interactions
Levomilnacipran + Ribociclib
Severity: Moderate
Levomilnacipran 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
Levomilnacipran is partly metabolized by CYP3A4, and its labeling advises a dose limit with strong CYP3A4 inhibitors. Ribociclib may raise levomilnacipran levels, increasing nausea, hypertension, tachycardia and other adverse effects.
What this interaction means in plain words
Levomilnacipran 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.
Levomilnacipran belongs to Central Nervous System; Ribociclib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated levomilnacipran metabolism by ribociclib.
What to do
Monitor blood pressure, heart rate and tolerability, and reduce the levomilnacipran dose if adverse effects appear.
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
Other interactions of Levomilnacipran
- Isocarboxazid + Levomilnacipran Contraindicated
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
Frequently asked questions
Can I take Levomilnacipran with Ribociclib?
MediHelp rates the interaction as moderate. Levomilnacipran 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. Levomilnacipran is partly metabolized by CYP3A4, and its labeling advises a dose limit with strong CYP3A4 inhibitors. Ribociclib may raise levomilnacipran levels, increasing nausea, hypertension, tachycardia and other adverse effects.
How serious is the interaction between Levomilnacipran 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 pressure, heart rate and tolerability, and reduce the levomilnacipran dose if adverse effects appear.
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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