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Interactions médicamenteuses

Levoketoconazole + Ribociclib

Gravité: Contre-indiquée

Levoketoconazole and Ribociclib: contraindicated interaction.

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Résumé

Levoketoconazole is a strong CYP3A4 inhibitor that increases ribociclib exposure, and both drugs prolong the QT interval. Ribociclib may also modestly raise levoketoconazole levels, so arrhythmia risk is substantially increased.

Ce que signifie cette interaction, en termes simples

Levoketoconazole and Ribociclib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Levoketoconazole belongs to Endocrine; Ribociclib belongs to Oncology.

Niveau de preuve: Moderate

Pourquoi elle survient

CYP3A4 inhibition raising ribociclib exposure combined with additive QTc prolongation.

Conduite à tenir

Avoid the combination, and consider alternative therapy for either drug. If a strong inhibitor is unavoidable, reduce ribociclib to 400 mg daily with close ECG and electrolyte monitoring.

Questions à poser à votre pharmacien

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Levoketoconazole with Ribociclib?

MediHelp rates the interaction as contraindicated. Levoketoconazole and Ribociclib are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Levoketoconazole is a strong CYP3A4 inhibitor that increases ribociclib exposure, and both drugs prolong the QT interval. Ribociclib may also modestly raise levoketoconazole levels, so arrhythmia risk is substantially increased.

How serious is the interaction between Levoketoconazole and Ribociclib?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination, and consider alternative therapy for either drug. If a strong inhibitor is unavoidable, reduce ribociclib to 400 mg daily with close ECG and electrolyte monitoring.

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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