Drug interactions
Ribociclib + Tolvaptan
Severity: Major
Ribociclib and Tolvaptan: 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 inhibits CYP3A4 and may increase tolvaptan exposure. This raises the risk of excessive aquaresis, dehydration and rapid sodium rise.
What this interaction means in plain words
Ribociclib and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Ribociclib inhibits CYP3A4 metabolism of tolvaptan.
What to do
Avoid or reduce the tolvaptan dose and monitor serum sodium and fluid status frequently.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Ribociclib with Tolvaptan?
MediHelp rates the interaction as major. Ribociclib and Tolvaptan 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 inhibits CYP3A4 and may increase tolvaptan exposure. This raises the risk of excessive aquaresis, dehydration and rapid sodium rise.
How serious is the interaction between Ribociclib and Tolvaptan?
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 or reduce the tolvaptan dose and monitor serum sodium and fluid status frequently.
What other medicines interact with Ribociclib?
MediHelp also lists interactions of Ribociclib with, for example, Amiodarone, Cisapride, Dofetilide. The full list is on the Ribociclib page.
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