Drug interactions
Ribociclib + Zanubrutinib
Severity: Moderate
Ribociclib and Zanubrutinib: 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
Zanubrutinib is metabolized mainly by CYP3A4, and ribociclib is a moderate CYP3A4 inhibitor. Higher zanubrutinib exposure may increase the risk of neutropenia, bleeding and infection.
What this interaction means in plain words
Ribociclib and Zanubrutinib 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; Zanubrutinib belongs to Oncology.
Why it happens
Ribociclib inhibits CYP3A4, reducing zanubrutinib clearance.
What to do
Reduce zanubrutinib to 80 mg twice daily while the moderate CYP3A inhibitor is used, and monitor blood counts and bleeding. Resume the usual dose after ribociclib is stopped.
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 Ribociclib
- Amiodarone + Ribociclib Contraindicated
- Cisapride + Ribociclib Contraindicated
- Dofetilide + Ribociclib Contraindicated
- Dronedarone + Ribociclib Contraindicated
- Flibanserin + Ribociclib Contraindicated
- Ibutilide + Ribociclib Contraindicated
Other interactions of Zanubrutinib
Frequently asked questions
Can I take Ribociclib with Zanubrutinib?
MediHelp rates the interaction as moderate. Ribociclib and Zanubrutinib 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. Zanubrutinib is metabolized mainly by CYP3A4, and ribociclib is a moderate CYP3A4 inhibitor. Higher zanubrutinib exposure may increase the risk of neutropenia, bleeding and infection.
How serious is the interaction between Ribociclib and Zanubrutinib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce zanubrutinib to 80 mg twice daily while the moderate CYP3A inhibitor is used, and monitor blood counts and bleeding. Resume the usual dose after ribociclib is stopped.
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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