Drug interactions
Ranolazine + Ribociclib
Severity: Major
Ranolazine 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 prolong the QTc interval, and ribociclib also inhibits CYP3A4, which can raise ranolazine exposure. The combination increases the risk of torsades de pointes and other serious ventricular arrhythmias.
What this interaction means in plain words
Ranolazine 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.
Ranolazine belongs to Cardiovascular; Ribociclib belongs to Oncology.
Why it happens
Additive QT prolongation plus CYP3A4 inhibition by ribociclib increasing ranolazine concentrations.
What to do
Avoid the combination where possible and choose an alternative antianginal. If unavoidable, limit ranolazine dose, monitor ECG and keep potassium and magnesium 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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine 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 Ranolazine with Ribociclib?
MediHelp rates the interaction as major. Ranolazine 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 prolong the QTc interval, and ribociclib also inhibits CYP3A4, which can raise ranolazine exposure. The combination increases the risk of torsades de pointes and other serious ventricular arrhythmias.
How serious is the interaction between Ranolazine 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 where possible and choose an alternative antianginal. If unavoidable, limit ranolazine dose, monitor ECG and keep potassium and magnesium normal.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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