is predicted to increase the exposure to repaglinide.
Retigabine → see antiepileptics
Retinoids → see TABLE 5 p. 1375 (thromboembolism)
acitretin . adapalene . alitretinoin . bexarotene .isotretinoin . tazarotene .tretinoin.
▶ Avoid concomitant use of keratolytics in patients taking
▶ Since systemic absorption can follow topical application of
isotretinoin and tretinoin, the possibility of interactions
▶ Alcohol (beverage) potentially increases the concentration of
. Avoid and for 2 months after stopping acitretin.
▶ Antiarrhythmics (amiodarone) are predicted to increase the
alitretinoin. Adjust alitretinoin dose, p. 1262.
▶ Antifungals, azoles (fluconazole, itraconazole, ketoconazole,
miconazole, voriconazole) are predicted to increase the
alitretinoin. Adjust alitretinoin dose, p. 1262.
▶ Antifungals, azoles (fluconazole, ketoconazole, voriconazole) are
predicted to increase the risk of tretinoin toxicity when given
▶ Clopidogrel is predicted to increase the exposure to
alitretinoin. Adjust alitretinoin dose, p. 1262.oTheoretical
▶ Cobicistat is predicted to increase the exposure to alitretinoin.
Adjust alitretinoin dose, p. 1262.oTheoretical
▶ Fibrates (gemfibrozil) are predicted to increase the exposure to
alitretinoin. Adjust alitretinoin dose, p. 1262.oTheoretical
▶ Fibrates (gemfibrozil) increase the concentration of
▶ HIV-protease inhibitors are predicted to increase the exposure
Adjust alitretinoin dose, p. 1262.oTheoretical
▶ Macrolides (clarithromycin) are predicted to increase the
alitretinoin. Adjust alitretinoin dose, p. 1262.
▶ Acitretin is predicted to increase the concentration of
methotrexate. Avoid.oAnecdotal
▶ Retinoids (acitretin, alitretinoin, isotretinoin, tretinoin) increase
the risk of benign intracranial hypertension when given with
tetracyclines. Avoid.rAnecdotal
▶ Bexarotene is predicted to increase the risk of toxicity when
given with vitamin A. Adjust dose.oTheoretical
▶ Retinoids (acitretin, alitretinoin, isotretinoin) are predicted to
increase the risk of vitamin A toxicity when given with vitamin
▶ Tretinoin is predicted to increase the risk of vitamin A toxicity
when given with vitamin A. Avoid.rStudy
▶ Ribavirin is predicted to increase the exposure to didanosine.
▶ Ribavirin increases the risk of toxicity when given with
▶ Ribavirin increases the risk of anaemia and/or leucopenia
when given with zidovudine. Avoid.rStudy
Ribociclib → see TABLE 9 p. 1377 (QT-interval prolongation)
FOOD AND LIFESTYLE Avoid concomitant use of pomegranate
or pomegranate juice as it is predicted to increase ribociclib
▶ Ribociclib (high-dose) is predicted to increase the exposure to
alpha blockers (alfuzosin). Avoid.oTheoretical
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to ribociclib.oStudy → Also see TABLE 9 p. 1377
▶ Ribociclib (high-dose) is predicted to increase the exposure to
antiarrhythmics (amiodarone). Avoid.oTheoretical → Also
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to markedly decrease the
exposure to ribociclib. Avoid.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to
Study → Also see TABLE 9 p. 1377
ribociclib.o ▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to ribociclib. Avoid or
adjust ribociclib dose, p. 997.oStudy → Also see TABLE 9
is predicted to increase the exposure to ribociclib.
is predicted to decrease the exposure to ribociclib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to ribociclib.oStudy
▶ Ribociclib is predicted to increase the exposure to ciclosporin.
Use with caution and adjust dose.oTheoretical
▶ Cobicistat is predicted to increase the exposure to ribociclib.
Avoid or adjust ribociclib dose, p. 997.oStudy
is predicted to increase the exposure to ribociclib.
Study → Also see TABLE 9 p. 1377
is predicted to increase the exposure to digoxin.
is predicted to decrease the exposure to ribociclib.
Study → Also see TABLE 9 p. 1377
▶ Enzalutamide is predicted to markedly decrease the exposure
▶ Ribociclib (high-dose) is predicted to increase the exposure to
ergotamine. Avoid.oTheoretical
▶ Ribociclib is predicted to increase the exposure to everolimus.
Use with caution and adjust dose.oTheoretical
▶ Grapefruit juice is predicted to increase the exposure to
ribociclib. Avoid.oTheoretical
▶ HIV-protease inhibitors are predicted to increase the exposure
ribociclib dose, p. 997.o ▶ Idelalisib is predicted to increase the exposure to ribociclib.
Avoid or adjust ribociclib dose, p. 997.oStudy
is predicted to increase the exposure to ribociclib.
▶ Macrolides (clarithromycin) are predicted to increase the
ribociclib. Avoid or adjust ribociclib dose, p. 997.
Study → Also see TABLE 9 p. 1377
▶ Macrolides (erythromycin) are predicted to increase the
exposure to ribociclib.oStudy → Also see TABLE 9 p. 1377
BNF 78 Repaglinide — Ribociclib 1521
is predicted to increase the exposure to metformin.
▶ Ribociclib moderately increases the exposure to midazolam.
▶ Mitotane is predicted to markedly decrease the exposure to
is predicted to increase the exposure to ribociclib.
is predicted to decrease the exposure to ribociclib.
is predicted to increase the exposure to ribociclib.
Study → Also see TABLE 9 p. 1377
▶ Ribociclib is predicted to increase the exposure to opioids
. Use with caution and adjust dose.
▶ Ribociclib is predicted to increase the exposure to
phosphodiesterase type-5 inhibitors
Theoretical → Also see TABLE 9 p. 1377
(sildenafil). Avoid.o ▶ Ribociclib (high-dose) is predicted to increase the exposure to
pimozide. Avoid.oTheoretical → Also see TABLE 9 p. 1377
▶ Ribociclib (high-dose) is predicted to increase the exposure to
quetiapine. Avoid.oTheoretical
▶ Rifampicin is predicted to markedly decrease the exposure to
▶ Ribociclib is predicted to increase the exposure to sirolimus.
Use with caution and adjust dose.oTheoretical
▶ St John’s Wort is predicted to decrease the exposure to
▶ Ribociclib is predicted to increase the exposure to statins
(pravastatin, rosuvastatin).oTheoretical
▶ Ribociclib (high-dose) is predicted to increase the exposure to
statins (simvastatin). Avoid.oTheoretical
▶ Ribociclib is predicted to increase the exposure to tacrolimus.
Use with caution and adjust dose.oTheoretical
GENERAL INFORMATION Although some manufacturers class
rifabutin as a potent inducer of CYP3A4, clinical data suggests
it is potentially a weak inducer, and therefore the BNF does
not extrapolate the interactions of potent CYP3A4 inducers to
rifabutin. For those who wish to err on the side of caution, see
the interactions of rifampicin but bear in mind other
▶ Antifungals, azoles (fluconazole) increase the risk of uveitis
when given with rifabutin. Adjust dose.rStudy
▶ Antifungals, azoles (itraconazole, posaconazole) increase the
concentration of rifabutin and rifabutin decreases the
concentration of antifungals, azoles (itraconazole,
▶ Antifungals, azoles (ketoconazole) are predicted to increase the
concentration of rifabutin and rifabutin is predicted to
decrease the concentration of antifungals, azoles
(ketoconazole). Avoid.rTheoretical
▶ Antifungals, azoles (miconazole) are predicted to increase the
rifabutin. Use with caution and adjust dose.
▶ Rifabutin is predicted to decrease the exposure to antifungals,
azoles (isavuconazole). Avoid.rTheoretical
▶ Rifabutin decreases the concentration of antifungals, azoles
(voriconazole) and antifungals, azoles (voriconazole) increase
the concentration of rifabutin. Avoid or adjust voriconazole
▶ Rifabutin slightly decreases the exposure to antimalarials
slightly decreases the exposure to bictegravir. Avoid.
▶ Rifabutin is predicted to decrease the exposure to brigatinib.
▶ Rifabutin decreases the concentration of cobicistat and
cobicistat increases the exposure to rifabutin. Avoid or adjust
▶ Rifabutin is predicted to decrease the efficacy of combined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactions p. 794.rStudy
▶ Rifabutin decreases the exposure to dapsone.oStudy
▶ Rifabutin is predicted to decrease the efficacy of desogestrel.
Contraceptives, interactions p. 794.
▶ Rifabutin moderately decreases the exposure to doravirine.
Adjust doravirine dose, p. 644.rStudy
▶ Efavirenz slightly decreases the exposure to rifabutin. Adjust
▶ Rifabutin is predicted to decrease the efficacy of etonogestrel.
Contraceptives, interactions p. 794.
▶ Rifabutin decreases the exposure to etravirine.oStudy
▶ HIV-protease inhibitors (atazanavir, darunavir, fosamprenavir,
lopinavir, saquinavir, tipranavir) (boosted with ritonavir)
rifabutin. Monitor and adjust dose.
▶ HIV-protease inhibitors (ritonavir) markedly increase the
exposure to rifabutin. Avoid or adjust dose.rStudy
▶ Rifabutin is predicted to decrease the effects of hormone
replacement therapy.oAnecdotal
▶ Rifabutin is predicted to decrease the exposure to ledipasvir.
▶ Rifabutin is predicted to decrease the concentration of
▶ Rifabutin is predicted to decrease the efficacy of
levonorgestrel. For FSRH guidance, see Contraceptives,
interactions p. 794.rTheoretical
▶ Lumacaftor is predicted to decrease the exposure to rifabutin.
▶ Macrolides (azithromycin) increase the risk of neutropenia
when given with rifabutin.rStudy
▶ Macrolides (clarithromycin) increase the risk of uveitis when
given with rifabutin. Adjust dose.rStudy
▶ Macrolides (erythromycin) are predicted to increase the risk of
▶ Rifabutin is predicted to decrease the efficacy of
norethisterone. For FSRH guidance, see Contraceptives,
interactions p. 794.rAnecdotal
▶ Rifabutin slightly decreases the exposure to rilpivirine. Adjust
▶ Rifabutin is predicted to decrease the exposure to rolapitant.
▶ Rifabutin is predicted to decrease the exposure to sofosbuvir.
▶ Rifabutin is predicted to decrease the exposure to tenofovir
alafenamide. Avoid.oTheoretical
▶ Rifabutin is predicted to decrease the exposure to tezacaftor.
▶ Rifabutin decreases the efficacy of ulipristal. For FSRH
Contraceptives, interactions p. 794.r
▶ Rifabutin is predicted to decrease the concentration of
voxilaprevir. Avoid.rTheoretical
▶ Rifampicin is predicted to markedly decrease the exposure to
▶ Rifampicin is predicted to decrease the exposure to
is predicted to decrease the exposure to afatinib.
▶ Rifampicin is predicted to decrease the exposure to
▶ Rifampicin is predicted to decrease the exposure to aldosterone
antagonists (eplerenone). Avoid.oTheoretical
▶ Rifampicin decreases the exposure to aliskiren.oStudy
▶ Rifampicin is predicted to decrease the exposure to
alprazolam. Adjust dose.oTheoretical
transiently increases the exposure to ambrisentan.
▶ Rifampicin decreases the exposure to aminophylline. Adjust
▶ Rifampicin is predicted to decrease the exposure to
anaesthetics, local (ropivacaine).oTheoretical
▶ Antacids decrease the absorption of rifampicin. Rifampicin
should be taken 1 hour before antacids.oStudy
1522 Ribociclib — Rifampicin BNF 78
▶ Rifampicin is predicted to decrease the exposure to
(disopyramide, dronedarone). Avoid.r
▶ Rifampicin is predicted to decrease the efficacy of
antiarrhythmics (propafenone).oStudy
▶ Rifampicin is predicted to decrease the exposure to
anticholinesterases, centrally acting (donepezil).nStudy
▶ Antiepileptics (phenobarbital, primidone) are predicted to
decrease the exposure to rifampicin and rifampicin is predicted
to decrease the exposure to antiepileptics (phenobarbital,
primidone). Use with caution and adjust dose.oStudy
▶ Rifampicin slightly decreases the exposure to antiepileptics
(brivaracetam). Adjust dose.oStudy
▶ Rifampicin decreases the concentration of antiepileptics
. Use with caution and adjust dose.
▶ Rifampicin markedly increases the clearance of antiepileptics
(lamotrigine). Adjust lamotrigine dose, p. 318.oStudy
▶ Rifampicin is predicted to decrease the exposure to
(fluconazole). Adjust dose.oStudy
▶ Rifampicin is predicted to decrease the exposure to antifungals,
azoles (isavuconazole). Avoid.rStudy
▶ Rifampicin markedly decreases the exposure to antifungals,
azoles (itraconazole). Avoid and for 14 days after stopping
▶ Rifampicin markedly decreases the exposure to antifungals,
azoles (ketoconazole) and antifungals, azoles (ketoconazole)
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