Drug interactions
Ribociclib + Sirolimus
Severity: Moderate
Ribociclib and Sirolimus: 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
Ribociclib inhibits CYP3A4 and can increase exposure to sirolimus, a narrow therapeutic index substrate. Ribociclib also prolongs the QT interval and causes neutropenia and hepatotoxicity, so higher sirolimus exposure adds to the overall toxicity burden.
What this interaction means in plain words
Ribociclib and Sirolimus 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.
Ribociclib belongs to Oncology; Sirolimus belongs to Miscellaneous.
Why it happens
Ribociclib inhibits CYP3A4, reducing sirolimus metabolism.
What to do
Monitor sirolimus trough concentrations, blood counts and liver tests, and reduce the sirolimus dose as guided by levels.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus 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 Sirolimus?
MediHelp rates the interaction as moderate. Ribociclib and Sirolimus 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. Ribociclib inhibits CYP3A4 and can increase exposure to sirolimus, a narrow therapeutic index substrate. Ribociclib also prolongs the QT interval and causes neutropenia and hepatotoxicity, so higher sirolimus exposure adds to the overall toxicity burden.
How serious is the interaction between Ribociclib and Sirolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sirolimus trough concentrations, blood counts and liver tests, and reduce the sirolimus dose as guided by levels.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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