Drug interactions
Methylergonovine + Ribociclib
Severity: Major
Methylergonovine 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
Methylergonovine is a CYP3A4 substrate, and potent CYP3A4 inhibitors have been linked to ergotism with severe vasospasm and ischemia. Ribociclib is a moderate-to-strong CYP3A4 inhibitor and may raise ergot levels.
What this interaction means in plain words
Methylergonovine 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.
Why it happens
Inhibition of CYP3A4-mediated methylergonovine metabolism by ribociclib, increasing ergot vasoconstriction.
What to do
Avoid concurrent use where possible and choose an alternative uterotonic. If unavoidable, monitor for peripheral ischemia, paresthesias and hypertension.
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 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 Methylergonovine with Ribociclib?
MediHelp rates the interaction as major. Methylergonovine 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. Methylergonovine is a CYP3A4 substrate, and potent CYP3A4 inhibitors have been linked to ergotism with severe vasospasm and ischemia. Ribociclib is a moderate-to-strong CYP3A4 inhibitor and may raise ergot levels.
How serious is the interaction between Methylergonovine 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 concurrent use where possible and choose an alternative uterotonic. If unavoidable, monitor for peripheral ischemia, paresthesias and hypertension.
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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