Ribociclib and Asciminib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ribociclib
Asciminib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased asciminib exposure, increased CYP3A4 substrate exposure, increased risk of asciminib-related adverse effects and an increased risk of CYP3A4 substrate-related adverse effects
Interaction Deep Dive
Concomitant use of asciminib with strong CYP3A4 inhibitors that are also CYP3A4 substrate may increase exposure of asciminib and CYP3A4 substrates, which may increase the risk of adverse reactions. Avoid coadministration of asciminib 200 mg twice daily with a CYP3A4 substrate where minimal concentration changes may lead to serious adverse reactions. In patients receiving a total dose of asciminib 80 mg/day, closely monitor for adverse reactions when coadministered with concomitant use of drugs that are both strong CYP3A4 inhibitors and CYP3A4 substrates where minimal concentration changes may lead to serious adverse reactions1.
Why it happens (mechanism)
Inhibition of CYP3A4-metabolism of asciminib; inhibition of CYP3A4-substrate metabolism by asciminib
Literature reports
1 report — tap to read
a) The asciminib AUC (inf) and Cmax increased by 36% and 19%, respectively, following coadministration of a single asciminib dose of 40 mg with a strong CYP3A4 inhibitor (clarithromycin) 1.
Common questions
Can I take Ribociclib and Asciminib together?
Increased asciminib exposure, increased CYP3A4 substrate exposure, increased risk of asciminib-related adverse effects and an increased risk of CYP3A4 substrate-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ribociclib and Asciminib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Ribociclib or Asciminib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: SCEMBLIX® oral tablets, asciminib oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2025. DailyMed
Keep reading about Ribociclib
Keep reading about Asciminib
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