Drug interactions
Miconazole + Ribociclib
Severity: Major
Miconazole 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
Both drugs can prolong the QT interval, and oral or buccal miconazole inhibits CYP3A4, which may raise ribociclib exposure. The combination can increase the risk of QT prolongation and torsades de pointes.
What this interaction means in plain words
Miconazole 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.
Miconazole belongs to Anti Fungals; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by miconazole increasing ribociclib levels.
What to do
Avoid systemic miconazole where possible, or use an alternative antifungal. If combined, monitor ECG and electrolytes and consider reducing ribociclib dose.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Other interactions of Miconazole
Frequently asked questions
Can I take Miconazole with Ribociclib?
MediHelp rates the interaction as major. Miconazole 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 can prolong the QT interval, and oral or buccal miconazole inhibits CYP3A4, which may raise ribociclib exposure. The combination can increase the risk of QT prolongation and torsades de pointes.
How serious is the interaction between Miconazole 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 systemic miconazole where possible, or use an alternative antifungal. If combined, monitor ECG and electrolytes and consider reducing ribociclib dose.
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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