Drug interactions
Naloxegol + Ribociclib
Severity: Moderate
Naloxegol and Ribociclib: moderate 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
Naloxegol is a CYP3A4 and P-gp substrate and its exposure rises with CYP3A4 inhibitors. Ribociclib, a CYP3A4 inhibitor, can increase naloxegol levels, raising the risk of abdominal pain, diarrhea and opioid withdrawal symptoms. The labeling contraindicates strong inhibitors and advises dose reduction with moderate ones.
What this interaction means in plain words
Naloxegol and Ribociclib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Naloxegol belongs to Gastrointestinal Tract; Ribociclib belongs to Oncology.
Why it happens
Ribociclib inhibits CYP3A4 and reduces naloxegol first-pass metabolism.
What to do
Reduce naloxegol to 12.5 mg daily if coadministered, and monitor for gastrointestinal effects or opioid withdrawal. Consider an alternative laxative if symptoms occur.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Naloxegol
- Clarithromycin + Naloxegol Contraindicated
- Itraconazole + Naloxegol Contraindicated
- Ketoconazole + Naloxegol Contraindicated
- Naloxegol + Posaconazole Contraindicated
- Naloxegol + Voriconazole Contraindicated
- Bupropion-naltrexone + Naloxegol Major
Frequently asked questions
Can I take Naloxegol with Ribociclib?
MediHelp rates the interaction as moderate. Naloxegol and Ribociclib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Naloxegol is a CYP3A4 and P-gp substrate and its exposure rises with CYP3A4 inhibitors. Ribociclib, a CYP3A4 inhibitor, can increase naloxegol levels, raising the risk of abdominal pain, diarrhea and opioid withdrawal symptoms. The labeling contraindicates strong inhibitors and advises dose reduction with moderate ones.
How serious is the interaction between Naloxegol and Ribociclib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce naloxegol to 12.5 mg daily if coadministered, and monitor for gastrointestinal effects or opioid withdrawal. Consider an alternative laxative if symptoms occur.
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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