Ribociclib and Ibrutinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ribociclib
Ibrutinib
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 ibrutinib exposure
Interaction Deep Dive
The concomitant use of ibrutinib, a CYP3A substrate, with a strong CYP3A inhibitor may result in significantly increased ibrutinib concentrations. In a drug-interaction study, brief concomitant use of ibrutinib with a strong CYP3A inhibitor, ketoconazole, increased ibrutinib Cmax 29-fold and AUC 24-fold. Therefore, avoid concomitant use of a strong CYP3A inhibitor during ibrutinib therapy. For short-term use (7 days or less) of a strong CYP3A inhibitor, interrupt ibrutinib therapy. After discontinuation of a CYP3A inhibitor, resume previous dose of ibrutinib1.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of ibrutinib
Literature reports
1 report — tap to read
a) In a pharmacokinetic study in healthy volunteers (N=18), ibrutinib single doses of 120 mg and 40 mg were given on day 1 and 7, respectively, with ketoconazole 400 mg once daily given on days 4 through 9. Coadministration of ketoconazole increased ibrutinib Cmax 29-fold and AUC 24-fold 2.
Common questions
Can I take Ribociclib and Ibrutinib together?
Increased ibrutinib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ribociclib and Ibrutinib 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 Ibrutinib 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 (2)
- Product Information: IMBRUVICA(R) oral capsules, oral tablets, oral suspension, ibrutinib oral capsules, oral tablets, oral suspension. Pharmacyclics LLC (per FDA), South San Francisco, CA, 2022. DailyMed
- Product Information: IMBRUVICA(R) oral capsules, ibrutinib oral capsules. Pharmacyclics LLC (per manufacturer), Sunnyvale, CA, 2016. DailyMed
Keep reading about Ribociclib
Keep reading about Ibrutinib
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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