Drug interactions
Lovastatin + Ribociclib
Severity: Major
Lovastatin and Ribociclib: major interaction.
Last updated Sources: Health Canada product monograph
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 is a moderate CYP3A4 inhibitor at therapeutic doses and can raise exposure to sensitive CYP3A4 substrates. Lovastatin is highly dependent on CYP3A4, so higher levels with an increased risk of myopathy and rhabdomyolysis are likely.
What this interaction means in plain words
Lovastatin 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.
Lovastatin belongs to Cardiovascular; Ribociclib belongs to Oncology.
Why it happens
Ribociclib inhibits CYP3A4, reducing the metabolism of lovastatin and raising its systemic exposure.
What to do
Avoid lovastatin and use a statin not dependent on CYP3A4, such as pravastatin or rosuvastatin. If it must be continued, use a low dose and monitor for muscle symptoms.
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 Lovastatin
- Atazanavir + Lovastatin Contraindicated
- Clarithromycin + Lovastatin Contraindicated
- Cobicistat + Lovastatin Contraindicated
- Conivaptan + Lovastatin Contraindicated
- Darunavir + Lovastatin Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lovastatin 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 Lovastatin with Ribociclib?
MediHelp rates the interaction as major. Lovastatin 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 is a moderate CYP3A4 inhibitor at therapeutic doses and can raise exposure to sensitive CYP3A4 substrates. Lovastatin is highly dependent on CYP3A4, so higher levels with an increased risk of myopathy and rhabdomyolysis are likely.
How serious is the interaction between Lovastatin 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 lovastatin and use a statin not dependent on CYP3A4, such as pravastatin or rosuvastatin. If it must be continued, use a low dose and monitor for muscle symptoms.
What other medicines interact with Lovastatin?
MediHelp also lists interactions of Lovastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Lovastatin page.
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