Drug interactions
Ribociclib + Tacrolimus
Severity: Major
Ribociclib and Tacrolimus: 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 QT interval, and ribociclib also inhibits CYP3A4, which may raise tacrolimus concentrations. This can increase tacrolimus toxicity, including nephrotoxicity, neurotoxicity and arrhythmia.
What this interaction means in plain words
Ribociclib and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by ribociclib reducing tacrolimus clearance.
What to do
Avoid if possible. If combined, monitor ECG and electrolytes, check tacrolimus trough levels closely, and reduce the tacrolimus dose as needed.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus 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 Tacrolimus?
MediHelp rates the interaction as major. Ribociclib and Tacrolimus 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 QT interval, and ribociclib also inhibits CYP3A4, which may raise tacrolimus concentrations. This can increase tacrolimus toxicity, including nephrotoxicity, neurotoxicity and arrhythmia.
How serious is the interaction between Ribociclib and Tacrolimus?
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 if possible. If combined, monitor ECG and electrolytes, check tacrolimus trough levels closely, and reduce the tacrolimus dose as needed.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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