Drug interactions
Midostaurin + Ribociclib
Severity: Major
Midostaurin 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
Midostaurin is mainly metabolized by CYP3A4, and strong inhibitors substantially raise its exposure. Ribociclib may increase midostaurin levels, raising the risk of nausea, myelosuppression and QT prolongation, and both drugs affect QT.
What this interaction means in plain words
Midostaurin 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.
Midostaurin belongs to Oncology; Ribociclib belongs to Oncology.
Why it happens
CYP3A4 inhibition by ribociclib increases midostaurin exposure, with additive QT prolongation.
What to do
Monitor ECG, electrolytes and blood counts closely and watch for pulmonary toxicity. Consider an alternative to ribociclib if feasible.
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
Other interactions of Midostaurin
Frequently asked questions
Can I take Midostaurin with Ribociclib?
MediHelp rates the interaction as major. Midostaurin 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. Midostaurin is mainly metabolized by CYP3A4, and strong inhibitors substantially raise its exposure. Ribociclib may increase midostaurin levels, raising the risk of nausea, myelosuppression and QT prolongation, and both drugs affect QT.
How serious is the interaction between Midostaurin 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: Monitor ECG, electrolytes and blood counts closely and watch for pulmonary toxicity. Consider an alternative to ribociclib if feasible.
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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