Ribociclib and Ixabepilone Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ribociclib
Ixabepilone Injection
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 ixabepilone exposure and increase in the incidence and severity of adverse reactions
Interaction Deep Dive
Coadministration of ixabepilone, a CYP3A4 substrate, with a strong CYP3A4 inhibitor has increased ixabepilone plasma concentration, which may increase the incidence and severity of adverse reactions. In a drug interaction study, concomitant use of ixabepilone with ketoconazole, a strong CYP3A4 inhibitor, increased ixabepilone AUC by 79% compared with ixabepilone alone. Use should be avoided. If coadministration of a strong CYP3A4 inhibitor with ixabepilone cannot be avoided, reduce the dose of ixabepilone to 20 mg/m(2). If the strong inhibitor is discontinued, increase the ixabepilone dose (at 1 week after discontinuing the inhibitor) to that used before starting the strong inhibitor1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated ixabepilone metabolism
Literature reports
1 report — tap to read
a) Coadministration of ixabepilone with ketoconazole, a strong CYP3A4 inhibitor, increased ixabepilone AUC by 79% compared with ixabepilone alone 1.
Common questions
Can I take Ribociclib and Ixabepilone Injection together?
Increased ixabepilone exposure and increase in the incidence and severity of adverse reactions Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ribociclib and Ixabepilone Injection 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 Ixabepilone Injection 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: IXEMPRA(R) intravenous injection, ixabepilone intravenous injection. R-Pharm US LLC (per FDA), Princeton, NJ, 2022. DailyMed
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