Drug interactions
Propafenone + Ribociclib
Severity: Major
Propafenone 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 prolongs the QT interval in a dose-dependent way and inhibits CYP3A4, which can raise propafenone exposure. Together these effects raise the risk of torsades de pointes and conduction abnormalities.
What this interaction means in plain words
Propafenone 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.
Propafenone belongs to Cardiovascular; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation together with CYP3A4 inhibition by ribociclib that increases propafenone levels.
What to do
Avoid the combination and use a non-QT-prolonging antiarrhythmic. If unavoidable, monitor the ECG at baseline, after about two weeks and as clinically indicated, and keep electrolytes normal.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone 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 Propafenone with Ribociclib?
MediHelp rates the interaction as major. Propafenone 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 prolongs the QT interval in a dose-dependent way and inhibits CYP3A4, which can raise propafenone exposure. Together these effects raise the risk of torsades de pointes and conduction abnormalities.
How serious is the interaction between Propafenone 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 the combination and use a non-QT-prolonging antiarrhythmic. If unavoidable, monitor the ECG at baseline, after about two weeks and as clinically indicated, and keep electrolytes normal.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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