Drug interactions
Methadone + Ribociclib
Severity: Major
Methadone and Ribociclib: major 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
Ribociclib is a CYP3A4 inhibitor and can raise methadone concentrations. Both drugs prolong the QT interval, so the combination increases the risk of torsades de pointes as well as opioid toxicity.
What this interaction means in plain words
Methadone 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.
Methadone belongs to Musculoskeletal; Ribociclib belongs to Oncology.
Why it happens
CYP3A4 inhibition by ribociclib plus additive QT prolongation.
What to do
Avoid if possible. If it cannot be avoided, monitor ECG and electrolytes and watch for sedation, adjusting the methadone dose as needed.
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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Other interactions of Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone 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 Methadone with Ribociclib?
MediHelp rates the interaction as major. Methadone 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 CYP3A4 inhibitor and can raise methadone concentrations. Both drugs prolong the QT interval, so the combination increases the risk of torsades de pointes as well as opioid toxicity.
How serious is the interaction between Methadone 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 if possible. If it cannot be avoided, monitor ECG and electrolytes and watch for sedation, adjusting the methadone dose as needed.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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