Drug interactions
Ribociclib + Simvastatin
Severity: Major
Ribociclib and Simvastatin: 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 is a moderate CYP3A4 inhibitor at the labeled dose and can increase simvastatin concentrations. This raises the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Ribociclib and Simvastatin 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 belongs to Oncology; Simvastatin belongs to Cardiovascular.
Why it happens
Ribociclib inhibits CYP3A4, reducing simvastatin metabolism.
What to do
Avoid the combination if possible; switch to a statin less dependent on CYP3A4, such as rosuvastatin or pravastatin. If it is continued, use the lowest simvastatin dose and monitor for muscle symptoms.
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 Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin 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 Ribociclib with Simvastatin?
MediHelp rates the interaction as major. Ribociclib and Simvastatin 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 is a moderate CYP3A4 inhibitor at the labeled dose and can increase simvastatin concentrations. This raises the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Ribociclib and Simvastatin?
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 if possible; switch to a statin less dependent on CYP3A4, such as rosuvastatin or pravastatin. If it is continued, use the lowest simvastatin dose and monitor for muscle symptoms.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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