Kalydeco

Overview

ivacaftor

CFTR potentiator

• CYP3A4 substrate
• CYP2C9 inhibitor, weak
• CYP3A4 inhibitor, weak
• P-gp inhibitor, weak

• drug interactions apply only to Kalydeco (ivacaftor); see other ivacaftor products for potentially relevant interactions

Contraindicated

• cisapride
Kalydeco (ivacaftor)

+

cisapride

1 interaction

Contraindicated

ivacaftor + cisapride

contraindicated: combo may incr. cisapride levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• colchicine
Kalydeco (ivacaftor)

+

colchicine

1 interaction

Contraindicated

ivacaftor + colchicine

CV RISK REDUCTION: consider monitoring CK, myopathy s/sx; GOUT OR FMF: contraindicated in pts w/ renal or hepatic impairment; otherwise, use alternative or consider decr. colchicine dose during and x14 days after ivacaftor use: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• eliglustat
Kalydeco (ivacaftor)

+

eliglustat

1 interaction

Contraindicated

ivacaftor + eliglustat

CYP2D6 EM: contraindicated if Child-Pugh Class A and if also combined w/ moderate or strong CYP2D6 inhibitor; if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 IM: if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 PM: avoid combo: combo may incr. eliglustat levels, risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

Avoid/Use Alternative

• adagrasib
Kalydeco (ivacaftor)

+

adagrasib

1 interaction

Avoid/Use Alternative

ivacaftor + adagrasib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• alprazolam
Kalydeco (ivacaftor)

+

alprazolam

1 interaction

Avoid/Use Alternative

ivacaftor + alprazolam

use alternative or monitor respiratory rate; consider decr. alprazolam dose: combo may incr. alprazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• apalutamide
Kalydeco (ivacaftor)

+

apalutamide

1 interaction

Avoid/Use Alternative

ivacaftor + apalutamide

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• apixaban
Kalydeco (ivacaftor)

+

apixaban

1 interaction

Avoid/Use Alternative

ivacaftor + apixaban

ADULT PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, decr. apixaban 5mg bid or 10 mg bid dose by 50% or avoid combo if already on 2.5 mg bid; PEDS PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• aprepitant
Kalydeco (ivacaftor)

+

aprepitant

1 interaction

Avoid/Use Alternative

ivacaftor + aprepitant

if aprepitant 3-day regimen, pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd; aprepitant single dose-regimen OK: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• atazanavir
Kalydeco (ivacaftor)

+

atazanavir

1 interaction

Avoid/Use Alternative

ivacaftor + atazanavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• avacopan
Kalydeco (ivacaftor)

+

avacopan

1 interaction

Avoid/Use Alternative

ivacaftor + avacopan

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• berotralstat
Kalydeco (ivacaftor)

+

berotralstat

1 interaction

Avoid/Use Alternative

ivacaftor + berotralstat

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• bosentan
Kalydeco (ivacaftor)

+

bosentan

1 interaction

Avoid/Use Alternative

ivacaftor + bosentan

avoid combo: combo may incr. bosentan levels, risk of adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism possibly inhibited; hepatic metabolism induced)

• butalbital
Kalydeco (ivacaftor)

+

butalbital

1 interaction

Avoid/Use Alternative

ivacaftor + butalbital

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• carbamazepine
Kalydeco (ivacaftor)

+

carbamazepine

1 interaction

Avoid/Use Alternative

ivacaftor + carbamazepine

avoid combo: combo may incr. carbamazepine levels, risk of adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• cenobamate
Kalydeco (ivacaftor)

+

cenobamate

1 interaction

Avoid/Use Alternative

ivacaftor + cenobamate

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• ceritinib
Kalydeco (ivacaftor)

+

ceritinib

1 interaction

Avoid/Use Alternative

ivacaftor + ceritinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• chloramphenicol
Kalydeco (ivacaftor)

+

chloramphenicol

1 interaction

Avoid/Use Alternative

ivacaftor + chloramphenicol

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• clarithromycin
Kalydeco (ivacaftor)

+

clarithromycin

1 interaction

Avoid/Use Alternative

ivacaftor + clarithromycin

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• clofazimine
Kalydeco (ivacaftor)

+

clofazimine

1 interaction

Avoid/Use Alternative

ivacaftor + clofazimine

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• cobicistat
Kalydeco (ivacaftor)

+

cobicistat

1 interaction

Avoid/Use Alternative

ivacaftor + cobicistat

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• codeine
Kalydeco (ivacaftor)

+

codeine

1 interaction

Avoid/Use Alternative

ivacaftor + codeine

use alternative or monitor respiratory rate; consider decr. codeine dose: combo may incr. codeine and active metabolite morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, may incr. production of active metabolite morphine)

• conivaptan
Kalydeco (ivacaftor)

+

conivaptan

1 interaction

Avoid/Use Alternative

ivacaftor + conivaptan

pts <6 mo: avoid combo during and x7 days after conivaptan tx; pts >6 mo decr. ivacaftor dose during and x7 days after conivaptan tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metabolism inhibited)

• crizotinib
Kalydeco (ivacaftor)

+

crizotinib

1 interaction

Avoid/Use Alternative

ivacaftor + crizotinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• cyclosporine
Kalydeco (ivacaftor)

+

cyclosporine

1 interaction

Avoid/Use Alternative

ivacaftor + cyclosporine

pts <6 mo: avoid combo; pts >6 mo monitor cyclosporine levels, renal fxn and decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of serious infection, nephrotoxicity, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• dabigatran
Kalydeco (ivacaftor)

+

dabigatran

1 interaction

Avoid/Use Alternative

ivacaftor + dabigatran

ATRIAL FIBRILLATION: avoid combo if CrCl <30 mL/min; OTHER INDICATIONS: avoid combo if CrCl <50 mL/min; if dabigatran use for DVT/PE prophylaxis post-hip replacement and CrCl >50 mL/min, consider separating admin. at least 2h apart: combo may incr. dabigatran levels, risk of bleeding (including life-threatening), other adverse effects (P-gp-mediated transport inhibited)

• dabrafenib
Kalydeco (ivacaftor)

+

dabrafenib

1 interaction

Avoid/Use Alternative

ivacaftor + dabrafenib

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• danazol
Kalydeco (ivacaftor)

+

danazol

1 interaction

Avoid/Use Alternative

ivacaftor + danazol

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• darunavir
Kalydeco (ivacaftor)

+

darunavir

1 interaction

Avoid/Use Alternative

ivacaftor + darunavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• diltiazem
Kalydeco (ivacaftor)

+

diltiazem

1 interaction

Avoid/Use Alternative

ivacaftor + diltiazem

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• dronedarone
Kalydeco (ivacaftor)

+

dronedarone

1 interaction

Avoid/Use Alternative

ivacaftor + dronedarone

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• duvelisib
Kalydeco (ivacaftor)

+

duvelisib

1 interaction

Avoid/Use Alternative

ivacaftor + duvelisib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• efavirenz
Kalydeco (ivacaftor)

+

efavirenz

1 interaction

Avoid/Use Alternative

ivacaftor + efavirenz

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• encorafenib
Kalydeco (ivacaftor)

+

encorafenib

1 interaction

Avoid/Use Alternative

ivacaftor + encorafenib

avoid combo: combo may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• ensartinib
Kalydeco (ivacaftor)

+

ensartinib

1 interaction

Avoid/Use Alternative

ivacaftor + ensartinib

avoid combo: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (P-gp-mediated transport possibly inhibited)

• enzalutamide
Kalydeco (ivacaftor)

+

enzalutamide

1 interaction

Avoid/Use Alternative

ivacaftor + enzalutamide

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• erythromycin
Kalydeco (ivacaftor)

+

erythromycin

1 interaction

Avoid/Use Alternative

ivacaftor + erythromycin

pts <6 mo: avoid combo; pts >6 mo monitor ECG and decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• etravirine
Kalydeco (ivacaftor)

+

etravirine

1 interaction

Avoid/Use Alternative

ivacaftor + etravirine

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• fedratinib
Kalydeco (ivacaftor)

+

fedratinib

1 interaction

Avoid/Use Alternative

ivacaftor + fedratinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd; if fedratinib also combined w/ CYP2C19 inhibitor, monitor CBC, LFTs: combo may incr. levels of both drugs, risk of myelosuppression, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• fexinidazole
Kalydeco (ivacaftor)

+

fexinidazole

1 interaction

Avoid/Use Alternative

ivacaftor + fexinidazole

avoid combo: combo may decr. ivacaftor levels, efficacy; may decr. fexinidazole active metabolite levels, efficacy (hepatic metabolism induced; hepatic metabolism inhibited, decr. conversion to active metabolites)

• fluconazole
Kalydeco (ivacaftor)

+

fluconazole

1 interaction

Avoid/Use Alternative

ivacaftor + fluconazole

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• fosamprenavir
Kalydeco (ivacaftor)

+

fosamprenavir

1 interaction

Avoid/Use Alternative

ivacaftor + fosamprenavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• fosphenytoin
Kalydeco (ivacaftor)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

ivacaftor + fosphenytoin

avoid combo: combo may incr. phenytoin levels, risk of toxicity; may decr. ivacaftor levels, efficacy (hepatic metabolism possibly inhibited; hepatic metabolism induced)

• grapefruit
Kalydeco (ivacaftor)

+

grapefruit

1 interaction

Avoid/Use Alternative

ivacaftor + grapefruit

avoid grapefruit juice: combo may incr. ivacaftor levels, risk of adverse effects (GI metabolism inhibited)

• hydrocodone
Kalydeco (ivacaftor)

+

hydrocodone

1 interaction

Avoid/Use Alternative

ivacaftor + hydrocodone

use alternative or monitor respiratory rate, ECG; consider decr. (benz)hydrocodone dose: combo may incr. hydrocodone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• idelalisib
Kalydeco (ivacaftor)

+

idelalisib

1 interaction

Avoid/Use Alternative

ivacaftor + idelalisib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• imatinib
Kalydeco (ivacaftor)

+

imatinib

1 interaction

Avoid/Use Alternative

ivacaftor + imatinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• isavuconazonium
Kalydeco (ivacaftor)

+

isavuconazonium

1 interaction

Avoid/Use Alternative

ivacaftor + isavuconazonium

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• itraconazole
Kalydeco (ivacaftor)

+

itraconazole

1 interaction

Avoid/Use Alternative

ivacaftor + itraconazole

pts <6 mo: avoid combo during and x2wk after itraconazole tx; pts >6 mo decr. ivacaftor dose during and x2wk after itraconazole tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• ivosidenib
Kalydeco (ivacaftor)

+

ivosidenib

1 interaction

Avoid/Use Alternative

ivacaftor + ivosidenib

avoid combo: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• ketoconazole
Kalydeco (ivacaftor)

+

ketoconazole

1 interaction

Avoid/Use Alternative

ivacaftor + ketoconazole

pts <6 mo: avoid combo during and up to 1wk after ketoconazole tx; pts >6 mo decr. ivacaftor dose during and up to 1wk after ketoconazole tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• lefamulin
Kalydeco (ivacaftor)

+

lefamulin

1 interaction

Avoid/Use Alternative

ivacaftor + lefamulin

ORAL LEFAMULIN: pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd; IV lefamulin use OK: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• lenacapavir
Kalydeco (ivacaftor)

+

lenacapavir

1 interaction

Avoid/Use Alternative

ivacaftor + lenacapavir

pts <6 mo: avoid combo during and x9mo after lenacapavir tx; pts >6 mo decr. ivacaftor dose during and x9mo after lenacapavir tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• letermovir
Kalydeco (ivacaftor)

+

letermovir

1 interaction

Avoid/Use Alternative

ivacaftor + letermovir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• levoketoconazole
Kalydeco (ivacaftor)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

ivacaftor + levoketoconazole

pts <6 mo: avoid combo; pts >6 mo consider monitoring ECG and decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lonafarnib
Kalydeco (ivacaftor)

+

lonafarnib

1 interaction

Avoid/Use Alternative

ivacaftor + lonafarnib

consider monitoring HR, ECG, electrolytes; pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lopinavir/ritonavir
Kalydeco (ivacaftor)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

ivacaftor + lopinavir/ ritonavir

avoid combo: combo may incr. or decr. ivacaftor levels, incr. risk of adverse effects or decr. efficacy (hepatic metabolism altered)

• lorlatinib
Kalydeco (ivacaftor)

+

lorlatinib

1 interaction

Avoid/Use Alternative

ivacaftor + lorlatinib

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• lumacaftor/ivacaftor
Kalydeco (ivacaftor)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

ivacaftor + lumacaftor/ ivacaftor

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• mavacamten
Kalydeco (ivacaftor)

+

mavacamten

1 interaction

Avoid/Use Alternative

ivacaftor + mavacamten

avoid combo: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• meperidine
Kalydeco (ivacaftor)

+

meperidine

1 interaction

Avoid/Use Alternative

ivacaftor + meperidine

use alternative or monitor respiratory rate, ECG: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• methadone
Kalydeco (ivacaftor)

+

methadone

1 interaction

Avoid/Use Alternative

ivacaftor + methadone

use alternative or monitor respiratory rate, ECG; consider decr. methadone dose: combo may incr. methadone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• mifepristone
Kalydeco (ivacaftor)

+

mifepristone

1 interaction

Avoid/Use Alternative

ivacaftor + mifepristone

pts <6 mo: avoid combo during and x14 days after daily mifepristone use; pts >6 mo decr. ivacaftor dose during and x14 days after daily mifepristone use as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• mitapivat
Kalydeco (ivacaftor)

+

mitapivat

1 interaction

Avoid/Use Alternative

ivacaftor + mitapivat

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• mitotane
Kalydeco (ivacaftor)

+

mitotane

1 interaction

Avoid/Use Alternative

ivacaftor + mitotane

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• modafinil
Kalydeco (ivacaftor)

+

modafinil

1 interaction

Avoid/Use Alternative

ivacaftor + modafinil

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• nafcillin
Kalydeco (ivacaftor)

+

nafcillin

1 interaction

Avoid/Use Alternative

ivacaftor + nafcillin

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• nefazodone
Kalydeco (ivacaftor)

+

nefazodone

1 interaction

Avoid/Use Alternative

ivacaftor + nefazodone

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• nelfinavir
Kalydeco (ivacaftor)

+

nelfinavir

1 interaction

Avoid/Use Alternative

ivacaftor + nelfinavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• neratinib
Kalydeco (ivacaftor)

+

neratinib

1 interaction

Avoid/Use Alternative

ivacaftor + neratinib

avoid combo if also combined w/ strong-mod CYP3A4 inhibitor; otherwise, caution advised: combo may incr. neratinib levels, risk of adverse effects (P-gp-mediated transport inhibited)

• netupitant
Kalydeco (ivacaftor)

+

netupitant

1 interaction

Avoid/Use Alternative

ivacaftor + netupitant

pts <6 mo: avoid combo during and x1wk after (fos)netupitant tx; pts >6 mo use alternative or decr. ivacaftor dose during and x1wk after (fos)netupitant tx as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• nilotinib
Kalydeco (ivacaftor)

+

nilotinib

1 interaction

Avoid/Use Alternative

ivacaftor + nilotinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• nirogacestat
Kalydeco (ivacaftor)

+

nirogacestat

1 interaction

Avoid/Use Alternative

ivacaftor + nirogacestat

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• oxycodone
Kalydeco (ivacaftor)

+

oxycodone

1 interaction

Avoid/Use Alternative

ivacaftor + oxycodone

use alternative or monitor respiratory rate; consider decr. oxycodone dose: combo may incr. oxycodone levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• pacritinib
Kalydeco (ivacaftor)

+

pacritinib

1 interaction

Avoid/Use Alternative

ivacaftor + pacritinib

avoid combo: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (including life-threatening), other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• pentobarbital
Kalydeco (ivacaftor)

+

pentobarbital

1 interaction

Avoid/Use Alternative

ivacaftor + pentobarbital

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• pexidartinib
Kalydeco (ivacaftor)

+

pexidartinib

1 interaction

Avoid/Use Alternative

ivacaftor + pexidartinib

avoid combo: combo may decr. ivacaftor levels, efficacy; may incr. pexidartinib levels, risk of hepatotoxicity, other adverse effects (hepatic metabolism induced; hepatic metabolism inhibited)

• phenobarbital
Kalydeco (ivacaftor)

+

phenobarbital

1 interaction

Avoid/Use Alternative

ivacaftor + phenobarbital

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• phenytoin
Kalydeco (ivacaftor)

+

phenytoin

1 interaction

Avoid/Use Alternative

ivacaftor + phenytoin

avoid combo: combo may incr. phenytoin levels, risk of toxicity; may decr. ivacaftor levels, efficacy (hepatic metabolism possibly inhibited; hepatic metabolism induced)

• pimozide
Kalydeco (ivacaftor)

+

pimozide

1 interaction

Avoid/Use Alternative

ivacaftor + pimozide

use alternative or monitor ECG: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• posaconazole
Kalydeco (ivacaftor)

+

posaconazole

1 interaction

Avoid/Use Alternative

ivacaftor + posaconazole

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• pralsetinib
Kalydeco (ivacaftor)

+

pralsetinib

1 interaction

Avoid/Use Alternative

ivacaftor + pralsetinib

use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• primidone
Kalydeco (ivacaftor)

+

primidone

1 interaction

Avoid/Use Alternative

ivacaftor + primidone

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• propafenone
Kalydeco (ivacaftor)

+

propafenone

1 interaction

Avoid/Use Alternative

ivacaftor + propafenone

if CYP2D6 poor metabolizer or if also combined w/ CYP2D6 inhibitor, avoid combo: combo may incr. propafenone levels, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (hepatic metabolism inhibited)

• relugolix
Kalydeco (ivacaftor)

+

relugolix

1 interaction

Avoid/Use Alternative

ivacaftor + relugolix

PROSTATE CANCER: may hold relugolix if ivacaftor tx up to 2wk; otherwise, use alternative or monitor ECG, electrolytes and admin. relugolix at least 6h before ivacaftor; FIBROID-ASSOC. BLEEDING: use alternative or admin. relugolix at least 6h before ivacaftor: combo may incr. relugolix levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• repotrectinib
Kalydeco (ivacaftor)

+

repotrectinib

1 interaction

Avoid/Use Alternative

ivacaftor + repotrectinib

avoid combo: combo may incr. repotrectinib levels, risk of adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited, P-gp-mediated transport inhibited; hepatic metabolism induced)

• ribociclib
Kalydeco (ivacaftor)

+

ribociclib

1 interaction

Avoid/Use Alternative

ivacaftor + ribociclib

pts <6 mo: avoid combo; pts >6 mo monitor ECG, electrolytes, CBC and decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. levels of both drugs, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• rifabutin
Kalydeco (ivacaftor)

+

rifabutin

1 interaction

Avoid/Use Alternative

ivacaftor + rifabutin

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• rifampin
Kalydeco (ivacaftor)

+

rifampin

1 interaction

Avoid/Use Alternative

ivacaftor + rifampin

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• rifapentine
Kalydeco (ivacaftor)

+

rifapentine

1 interaction

Avoid/Use Alternative

ivacaftor + rifapentine

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• rilzabrutinib
Kalydeco (ivacaftor)

+

rilzabrutinib

1 interaction

Avoid/Use Alternative

ivacaftor + rilzabrutinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of adverse effects (hepatic metabolism inhibited)

• ritonavir
Kalydeco (ivacaftor)

+

ritonavir

1 interaction

Avoid/Use Alternative

ivacaftor + ritonavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• rivaroxaban
Kalydeco (ivacaftor)

+

rivaroxaban

1 interaction

Avoid/Use Alternative

ivacaftor + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• simvastatin
Kalydeco (ivacaftor)

+

simvastatin

1 interaction

Avoid/Use Alternative

ivacaftor + simvastatin

use alternative or monitor CK, myopathy sx; adjust max simvastatin dose to 20 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• sirolimus albumin-bound
Kalydeco (ivacaftor)

+

sirolimus albumin-bound

1 interaction

Avoid/Use Alternative

ivacaftor + sirolimus albumin-bound

avoid combo: combo may incr. sirolimus albumin-bound levels, risk of serious infection, myelosuppression, bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• sotorasib
Kalydeco (ivacaftor)

+

sotorasib

1 interaction

Avoid/Use Alternative

ivacaftor + sotorasib

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• St. John's wort
Kalydeco (ivacaftor)

+

St. John's wort

1 interaction

Avoid/Use Alternative

ivacaftor + St. John's wort

avoid combo: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• tipranavir
Kalydeco (ivacaftor)

+

tipranavir

1 interaction

Avoid/Use Alternative

ivacaftor + tipranavir

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• topotecan
Kalydeco (ivacaftor)

+

topotecan

1 interaction

Avoid/Use Alternative

ivacaftor + topotecan

avoid combo w/ oral topotecan: combo may incr. topotecan levels, risk of serious infection, myelosuppression, other adverse effects (gut P-gp-mediated transport inhibited)

• tucatinib
Kalydeco (ivacaftor)

+

tucatinib

1 interaction

Avoid/Use Alternative

ivacaftor + tucatinib

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

• venetoclax
Kalydeco (ivacaftor)

+

venetoclax

1 interaction

Avoid/Use Alternative

ivacaftor + venetoclax

monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50%; AML: decr. venetoclax dose by at least 50%: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• verapamil
Kalydeco (ivacaftor)

+

verapamil

1 interaction

Avoid/Use Alternative

ivacaftor + verapamil

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg qd; 6 mo-5 yo and 7-13.9 kg: give 50 mg qd; 6 mo-5 yo and >14 kg: give 75 mg qd; 6 yo and older: give 150 mg qd: combo may incr. levels of both drugs, risk of hypotension, bradycardia, AV block, other adverse effects (hepatic metabolism inhibited)

• voriconazole
Kalydeco (ivacaftor)

+

voriconazole

1 interaction

Avoid/Use Alternative

ivacaftor + voriconazole

pts <6 mo: avoid combo; pts >6 mo decr. ivacaftor dose as follows: 6 mo-5 yo and 5-6.9 kg: give 25 mg 2x/wk; 6 mo-5 yo and 7-13.9 kg: give 50 mg 2x/wk; 6 mo-5 yo and >14 kg: give 75 mg 2x/wk; 6 yo and older: give 150 mg 2x/wk: combo may incr. ivacaftor levels, risk of adverse effects (hepatic metabolism inhibited)

Monitor/Modify Tx

• abemaciclib
Kalydeco (ivacaftor)

+

abemaciclib

1 interaction

Monitor/Modify Tx

ivacaftor + abemaciclib

monitor CBC: combo may incr. abemaciclib levels, risk of serious infection, myelosuppression, thrombosis risk, other adverse effects (hepatic metabolism inhibited)

• acalabrutinib
Kalydeco (ivacaftor)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

ivacaftor + acalabrutinib

monitor CBC: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• afatinib
Kalydeco (ivacaftor)

+

afatinib

1 interaction

Monitor/Modify Tx

ivacaftor + afatinib

decr. afatinib dose by 10 mg/day if not tolerated: combo may incr. afatinib levels, risk of adverse effects (P-gp-mediated transport inhibited)

• aficamten
Kalydeco (ivacaftor)

+

aficamten

1 interaction

Monitor/Modify Tx

ivacaftor + aficamten

monitor cardiac fxn, incl. LVEF: combo may incr. aficamten levels, risk of cardiotoxicity, other adverse effects (hepatic metabolism possibly inhibited)

• alfentanil
Kalydeco (ivacaftor)

+

alfentanil

1 interaction

Monitor/Modify Tx

ivacaftor + alfentanil

monitor respiratory rate; consider decr. alfentanil dose: combo may incr. alfentanil levels, risk of CNS and respiratory depression, psychomotor impairment, delayed recovery from anesthesia, other adverse effects (hepatic metabolism inhibited)

• amiodarone
Kalydeco (ivacaftor)

+

amiodarone

1 interaction

Monitor/Modify Tx

ivacaftor + amiodarone

monitor ECG: combo may incr. amiodarone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• atorvastatin
Kalydeco (ivacaftor)

+

atorvastatin

1 interaction

Monitor/Modify Tx

ivacaftor + atorvastatin

monitor CK, myopathy sx: combo may incr. atorvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (P-gp-mediated transport inhibited)

• avanafil
Kalydeco (ivacaftor)

+

avanafil

1 interaction

Monitor/Modify Tx

ivacaftor + avanafil

monitor BP; consider decr. avanafil dose: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• avapritinib
Kalydeco (ivacaftor)

+

avapritinib

1 interaction

Monitor/Modify Tx

ivacaftor + avapritinib

monitor bleeding s/sx: combo may incr. avapritinib levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• brigatinib
Kalydeco (ivacaftor)

+

brigatinib

1 interaction

Monitor/Modify Tx

ivacaftor + brigatinib

monitor BP, HR: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• capivasertib
Kalydeco (ivacaftor)

+

capivasertib

1 interaction

Monitor/Modify Tx

ivacaftor + capivasertib

monitor glucose: combo may incr. capivasertib levels, risk of severe hyperglycemia, other adverse effects (hepatic metabolism inhibited)

• celecoxib
Kalydeco (ivacaftor)

+

celecoxib

1 interaction

Monitor/Modify Tx

ivacaftor + celecoxib

monitor bleeding s/sx: combo may incr. celecoxib levels, risk of GI or other bleeding (including life-threatening), other adverse effects (hepatic metabolism possibly inhibited)

• clozapine
Kalydeco (ivacaftor)

+

clozapine

1 interaction

Monitor/Modify Tx

ivacaftor + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (hepatic metabolism inhibited)

• deuruxolitinib
Kalydeco (ivacaftor)

+

deuruxolitinib

1 interaction

Monitor/Modify Tx

ivacaftor + deuruxolitinib

monitor CBC, thrombosis s/sx: combo may incr. deuruxolitinib levels, risk of serious infection, thromboembolism, myelosuppression, other adverse effects (hepatic metabolism possibly inhibited)

• diclofenac
Kalydeco (ivacaftor)

+

diclofenac

1 interaction

Monitor/Modify Tx

ivacaftor + diclofenac

monitor bleeding s/sx; use lowest effective diclofenac dose, shortest duration of concomitant tx: combo may incr. diclofenac levels, risk of GI or other bleeding (including life-threatening), other adverse effects (hepatic metabolism possibly inhibited)

• digoxin
Kalydeco (ivacaftor)

+

digoxin

1 interaction

Monitor/Modify Tx

ivacaftor + digoxin

monitor digoxin levels, HR; decr. digoxin frequency or dose by 15-30%: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects (P-gp-mediated transport inhibited)

• disopyramide
Kalydeco (ivacaftor)

+

disopyramide

1 interaction

Monitor/Modify Tx

ivacaftor + disopyramide

monitor disopyramide levels: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• docetaxel
Kalydeco (ivacaftor)

+

docetaxel

1 interaction

Monitor/Modify Tx

ivacaftor + docetaxel

monitor CBC: combo may incr. docetaxel levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• dofetilide
Kalydeco (ivacaftor)

+

dofetilide

1 interaction

Monitor/Modify Tx

ivacaftor + dofetilide

monitor ECG: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• domperidone
Kalydeco (ivacaftor)

+

domperidone

1 interaction

Monitor/Modify Tx

ivacaftor + domperidone

monitor ECG, HR, electrolytes: combo may incr. domperidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• edoxaban
Kalydeco (ivacaftor)

+

edoxaban

1 interaction

Monitor/Modify Tx

ivacaftor + edoxaban

monitor bleeding s/sx: combo may incr. edoxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

• enfortumab vedotin
Kalydeco (ivacaftor)

+

enfortumab vedotin

1 interaction

Monitor/Modify Tx

ivacaftor + enfortumab vedotin

if also combined w/ strong CYP3A4 inhibitor, monitor CBC, glucose: combo may incr. enfortumab vedotin levels, risk of myelosuppression, neuropathy, hyperglycemia, other adverse effects (P-gp-mediated transport inhibited)

• entrectinib
Kalydeco (ivacaftor)

+

entrectinib

1 interaction

Monitor/Modify Tx

ivacaftor + entrectinib

monitor ECG, CBC: combo may incr. entrectinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• eplerenone
Kalydeco (ivacaftor)

+

eplerenone

1 interaction

Monitor/Modify Tx

ivacaftor + eplerenone

monitor potassium: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• everolimus
Kalydeco (ivacaftor)

+

everolimus

1 interaction

Monitor/Modify Tx

ivacaftor + everolimus

TSC-ASSOC. SEGA, TSC-ASSOC. PARTIAL ONSET SEIZURES, TRANSPLANT: monitor everolimus levels, CBC; OTHER INDICATIONS: monitor CBC: combo may incr. everolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• felodipine
Kalydeco (ivacaftor)

+

felodipine

1 interaction

Monitor/Modify Tx

ivacaftor + felodipine

monitor BP, HR: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (hepatic metabolism inhibited)

• fentanyl
Kalydeco (ivacaftor)

+

fentanyl

1 interaction

Monitor/Modify Tx

ivacaftor + fentanyl

monitor respiratory rate; consider decr. fentanyl dose: combo may incr. fentanyl levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• finerenone
Kalydeco (ivacaftor)

+

finerenone

1 interaction

Monitor/Modify Tx

ivacaftor + finerenone

monitor potassium: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• flibanserin
Kalydeco (ivacaftor)

+

flibanserin

1 interaction

Monitor/Modify Tx

ivacaftor + flibanserin

monitor BP, especially if flibanserin also combined w/ other weak CYP3A4 inhibitors: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (hepatic metabolism inhibited)

• fluvastatin
Kalydeco (ivacaftor)

+

fluvastatin

1 interaction

Monitor/Modify Tx

ivacaftor + fluvastatin

monitor CK, myopathy sx: combo may incr. fluvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism possibly inhibited)

• gepirone
Kalydeco (ivacaftor)

+

gepirone

1 interaction

Monitor/Modify Tx

ivacaftor + gepirone

monitor ECG, electrolytes: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• glimepiride
Kalydeco (ivacaftor)

+

glimepiride

1 interaction

Monitor/Modify Tx

ivacaftor + glimepiride

monitor glucose: combo may incr. glimepiride levels, risk of hypoglycemia, other adverse effects (hepatic metabolism possibly inhibited)

• glipizide
Kalydeco (ivacaftor)

+

glipizide

1 interaction

Monitor/Modify Tx

ivacaftor + glipizide

monitor glucose: combo may incr. glipizide levels, risk of hypoglycemia, other adverse effects (hepatic metabolism possibly inhibited)

• ibrutinib
Kalydeco (ivacaftor)

+

ibrutinib

1 interaction

Monitor/Modify Tx

ivacaftor + ibrutinib

consider decr. ibrutinib dose: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• ivabradine
Kalydeco (ivacaftor)

+

ivabradine

1 interaction

Monitor/Modify Tx

ivacaftor + ivabradine

monitor HR, ECG: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ixabepilone
Kalydeco (ivacaftor)

+

ixabepilone

1 interaction

Monitor/Modify Tx

ivacaftor + ixabepilone

monitor CBC: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other toxicity (hepatic metabolism inhibited)

• lemborexant
Kalydeco (ivacaftor)

+

lemborexant

1 interaction

Monitor/Modify Tx

ivacaftor + lemborexant

adjust max lemborexant dose to 5 mg/day: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• lomitapide
Kalydeco (ivacaftor)

+

lomitapide

1 interaction

Monitor/Modify Tx

ivacaftor + lomitapide

ADULT PATIENTS: if patient on stable ivacaftor dose and starting lomitapide, adjust max lomitapide dose to 30 mg/day; if patient on stable lomitapide dose and starting ivacaftor, decr. lomitapide dose by 50% and adjust max lomitapide dose to 30 mg/day; PEDIATRIC PATIENTS: if patient on stable ivacaftor dose and starting lomitapide, adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo; if patient on stable lomitapide dose and starting ivacaftor, decr. lomitapide dose by 50% and adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo: combo may incr. lomitapide levels, risk of hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• lovastatin
Kalydeco (ivacaftor)

+

lovastatin

1 interaction

Monitor/Modify Tx

ivacaftor + lovastatin

monitor CK, myopathy sx: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• lumateperone
Kalydeco (ivacaftor)

+

lumateperone

1 interaction

Monitor/Modify Tx

ivacaftor + lumateperone

monitor ECG: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lurasidone
Kalydeco (ivacaftor)

+

lurasidone

1 interaction

Monitor/Modify Tx

ivacaftor + lurasidone

monitor ECG: combo may incr. lurasidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lurbinectedin
Kalydeco (ivacaftor)

+

lurbinectedin

1 interaction

Monitor/Modify Tx

ivacaftor + lurbinectedin

monitor CBC: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• mavorixafor
Kalydeco (ivacaftor)

+

mavorixafor

1 interaction

Monitor/Modify Tx

ivacaftor + mavorixafor

monitor ECG: combo may incr. mavorixafor levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (P-gp-mediated transport inhibited)

• midazolam
Kalydeco (ivacaftor)

+

midazolam

1 interaction

Monitor/Modify Tx

ivacaftor + midazolam

monitor respiratory rate: combo may incr. midazolam and active metabolite levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• mobocertinib
Kalydeco (ivacaftor)

+

mobocertinib

1 interaction

Monitor/Modify Tx

ivacaftor + mobocertinib

monitor ECG: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• morphine
Kalydeco (ivacaftor)

+

morphine

1 interaction

Monitor/Modify Tx

ivacaftor + morphine

monitor respiratory rate, consider decr. dose of one or both drugs: combo may incr. morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (P-gp-mediated transport inhibited)

• nifedipine
Kalydeco (ivacaftor)

+

nifedipine

1 interaction

Monitor/Modify Tx

ivacaftor + nifedipine

monitor BP, consider lowest nifedipine start dose: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nimodipine
Kalydeco (ivacaftor)

+

nimodipine

1 interaction

Monitor/Modify Tx

ivacaftor + nimodipine

monitor BP: combo may incr. nimodipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nisoldipine
Kalydeco (ivacaftor)

+

nisoldipine

1 interaction

Monitor/Modify Tx

ivacaftor + nisoldipine

monitor BP: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• oliceridine
Kalydeco (ivacaftor)

+

oliceridine

1 interaction

Monitor/Modify Tx

ivacaftor + oliceridine

monitor respiratory rate, ECG: combo may incr. oliceridine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• pemigatinib
Kalydeco (ivacaftor)

+

pemigatinib

1 interaction

Monitor/Modify Tx

ivacaftor + pemigatinib

monitor phosphate: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metabolism inhibited)

• quinidine (antiarrhythmic)
Kalydeco (ivacaftor)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

ivacaftor + quinidine (antiarrhythmic)

monitor quinidine levels, ECG: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• ranolazine
Kalydeco (ivacaftor)

+

ranolazine

1 interaction

Monitor/Modify Tx

ivacaftor + ranolazine

monitor ECG: combo may incr. ranolazine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (P-gp-mediated transport inhibited)

• red yeast rice
Kalydeco (ivacaftor)

+

red yeast rice

1 interaction

Monitor/Modify Tx

ivacaftor + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, red yeast rice contains varying amounts of lovastatin)

• selpercatinib
Kalydeco (ivacaftor)

+

selpercatinib

1 interaction

Monitor/Modify Tx

ivacaftor + selpercatinib

monitor ECG, electrolytes: combo may incr. selpercatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• sirolimus
Kalydeco (ivacaftor)

+

sirolimus

1 interaction

Monitor/Modify Tx

ivacaftor + sirolimus

monitor sirolimus levels: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• sufentanil
Kalydeco (ivacaftor)

+

sufentanil

1 interaction

Monitor/Modify Tx

ivacaftor + sufentanil

monitor respiratory rate, consider decr. sufentanil dose or frequency: combo may incr. sufentanil levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• tacrolimus
Kalydeco (ivacaftor)

+

tacrolimus

1 interaction

Monitor/Modify Tx

ivacaftor + tacrolimus

monitor tacrolimus levels, ECG, renal fxn: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, other adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• tadalafil
Kalydeco (ivacaftor)

+

tadalafil

1 interaction

Monitor/Modify Tx

ivacaftor + tadalafil

monitor BP: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• talazoparib
Kalydeco (ivacaftor)

+

talazoparib

1 interaction

Monitor/Modify Tx

ivacaftor + talazoparib

monitor CBC: combo may incr. talazoparib levels, risk of myelosuppression, other adverse effects (P-gp-mediated transport inhibited)

• taletrectinib
Kalydeco (ivacaftor)

+

taletrectinib

1 interaction

Monitor/Modify Tx

ivacaftor + taletrectinib

monitor ECG: combo may incr. taletrectinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• temsirolimus
Kalydeco (ivacaftor)

+

temsirolimus

1 interaction

Monitor/Modify Tx

ivacaftor + temsirolimus

monitor CBC: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• tenofovir alafenamide
Kalydeco (ivacaftor)

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

ivacaftor + tenofovir alafenamide

if tenofovir alafenamide not admin. w/ cobicistat, monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport inhibited)

• tenofovir disoproxil
Kalydeco (ivacaftor)

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

ivacaftor + tenofovir disoproxil

monitor renal fxn: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport inhibited)

• tolvaptan
Kalydeco (ivacaftor)

+

tolvaptan

1 interaction

Monitor/Modify Tx

ivacaftor + tolvaptan

consider decr. tolvaptan dose: combo may incr. tolvaptan levels, risk of adverse effects (hepatic metabolism inhibited)

• torsemide
Kalydeco (ivacaftor)

+

torsemide

1 interaction

Monitor/Modify Tx

ivacaftor + torsemide

monitor renal fxn, BP: combo may incr. torsemide levels, risk of nephrotoxicity, hypotension, other adverse effects (hepatic metabolism possibly inhibited)

• triazolam
Kalydeco (ivacaftor)

+

triazolam

1 interaction

Monitor/Modify Tx

ivacaftor + triazolam

monitor respiratory rate; consider decr. triazolam dose: combo may incr. triazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• ubrogepant
Kalydeco (ivacaftor)

+

ubrogepant

1 interaction

Monitor/Modify Tx

ivacaftor + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 2h if needed: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metabolism inhibited, P-gp-mediated transport inhibited)

• vardenafil
Kalydeco (ivacaftor)

+

vardenafil

1 interaction

Monitor/Modify Tx

ivacaftor + vardenafil

monitor ECG: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• vinblastine
Kalydeco (ivacaftor)

+

vinblastine

1 interaction

Monitor/Modify Tx

ivacaftor + vinblastine

monitor CBC: combo may incr. vinblastine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• vincristine
Kalydeco (ivacaftor)

+

vincristine

1 interaction

Monitor/Modify Tx

ivacaftor + vincristine

monitor CBC: combo may incr. vincristine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• vinorelbine
Kalydeco (ivacaftor)

+

vinorelbine

1 interaction

Monitor/Modify Tx

ivacaftor + vinorelbine

monitor CBC: combo may incr. vinorelbine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• warfarin
Kalydeco (ivacaftor)

+

warfarin

1 interaction

Monitor/Modify Tx

ivacaftor + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• zanubrutinib
Kalydeco (ivacaftor)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

ivacaftor + zanubrutinib

monitor CBC: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects; may decr. ivacaftor levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

Caution Advised

• armodafinil
Kalydeco (ivacaftor)

+

armodafinil

1 interaction

Caution Advised

ivacaftor + armodafinil

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• artemether/lumefantrine
Kalydeco (ivacaftor)

+

artemether/ lumefantrine

1 interaction

Caution Advised

ivacaftor + artemether/ lumefantrine

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• belzutifan
Kalydeco (ivacaftor)

+

belzutifan

1 interaction

Caution Advised

ivacaftor + belzutifan

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• bexarotene
Kalydeco (ivacaftor)

+

bexarotene

1 interaction

Caution Advised

ivacaftor + bexarotene

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• cariprazine
Kalydeco (ivacaftor)

+

cariprazine

1 interaction

Caution Advised

ivacaftor + cariprazine

caution advised: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metabolism inhibited)

• clobazam
Kalydeco (ivacaftor)

+

clobazam

1 interaction

Caution Advised

ivacaftor + clobazam

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• cobimetinib
Kalydeco (ivacaftor)

+

cobimetinib

1 interaction

Caution Advised

ivacaftor + cobimetinib

caution advised: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metabolism inhibited)

• cyclophosphamide
Kalydeco (ivacaftor)

+

cyclophosphamide

1 interaction

Caution Advised

ivacaftor + cyclophosphamide

caution advised: combo may decr. cyclophosphamide active metabolite levels, efficacy (hepatic metabolism possibly inhibited, decr. conversion to active metabolite)

• danshen
Kalydeco (ivacaftor)

+

danshen

1 interaction

Caution Advised

ivacaftor + danshen

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• daridorexant
Kalydeco (ivacaftor)

+

daridorexant

1 interaction

Caution Advised

ivacaftor + daridorexant

caution advised: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• darolutamide
Kalydeco (ivacaftor)

+

darolutamide

1 interaction

Caution Advised

ivacaftor + darolutamide

caution advised: combo may incr. darolutamide levels, risk of adverse effects; may decr. ivacaftor levels, efficacy (P-gp-mediated transport inhibited; hepatic metabolism induced)

• dexamethasone
Kalydeco (ivacaftor)

+

dexamethasone

1 interaction

Caution Advised

ivacaftor + dexamethasone

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• dicloxacillin
Kalydeco (ivacaftor)

+

dicloxacillin

1 interaction

Caution Advised

ivacaftor + dicloxacillin

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• dihydroergotamine
Kalydeco (ivacaftor)

+

dihydroergotamine

1 interaction

Caution Advised

ivacaftor + dihydroergotamine

caution advised: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• echinacea
Kalydeco (ivacaftor)

+

echinacea

1 interaction

Caution Advised

ivacaftor + echinacea

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• elafibranor
Kalydeco (ivacaftor)

+

elafibranor

1 interaction

Caution Advised

ivacaftor + elafibranor

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• elagolix
Kalydeco (ivacaftor)

+

elagolix

1 interaction

Caution Advised

ivacaftor + elagolix

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• elinzanetant
Kalydeco (ivacaftor)

+

elinzanetant

1 interaction

Caution Advised

ivacaftor + elinzanetant

caution advised: combo may incr. elinzanetant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• enasidenib
Kalydeco (ivacaftor)

+

enasidenib

1 interaction

Caution Advised

ivacaftor + enasidenib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• ergotamine
Kalydeco (ivacaftor)

+

ergotamine

1 interaction

Caution Advised

ivacaftor + ergotamine

caution advised: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• eslicarbazepine acetate
Kalydeco (ivacaftor)

+

eslicarbazepine acetate

1 interaction

Caution Advised

ivacaftor + eslicarbazepine acetate

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• felbamate
Kalydeco (ivacaftor)

+

felbamate

1 interaction

Caution Advised

ivacaftor + felbamate

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• garlic
Kalydeco (ivacaftor)

+

garlic

1 interaction

Caution Advised

ivacaftor + garlic

caution advised w/ supplemental garlic; dietary intake OK: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• ginkgo
Kalydeco (ivacaftor)

+

ginkgo

1 interaction

Caution Advised

ivacaftor + ginkgo

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• ginseng, Asian
Kalydeco (ivacaftor)

+

ginseng, Asian

1 interaction

Caution Advised

ivacaftor + ginseng, Asian

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• glecaprevir
Kalydeco (ivacaftor)

+

glecaprevir

1 interaction

Caution Advised

ivacaftor + glecaprevir

caution advised: combo may incr. glecaprevir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• glycerol phenylbutyrate
Kalydeco (ivacaftor)

+

glycerol phenylbutyrate

1 interaction

Caution Advised

ivacaftor + glycerol phenylbutyrate

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• griseofulvin
Kalydeco (ivacaftor)

+

griseofulvin

1 interaction

Caution Advised

ivacaftor + griseofulvin

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• meropenem
Kalydeco (ivacaftor)

+

meropenem

1 interaction

Caution Advised

ivacaftor + meropenem

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)

• methylergonovine
Kalydeco (ivacaftor)

+

methylergonovine

1 interaction

Caution Advised

ivacaftor + methylergonovine

caution advised: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• naldemedine
Kalydeco (ivacaftor)

+

naldemedine

1 interaction

Caution Advised

ivacaftor + naldemedine

caution advised: combo may incr. naldemedine levels, risk of adverse effects (P-gp-mediated transport inhibited)

• nevirapine
Kalydeco (ivacaftor)

+

nevirapine

1 interaction

Caution Advised

ivacaftor + nevirapine

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• odevixibat
Kalydeco (ivacaftor)

+

odevixibat

1 interaction

Caution Advised

ivacaftor + odevixibat

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• olutasidenib
Kalydeco (ivacaftor)

+

olutasidenib

1 interaction

Caution Advised

ivacaftor + olutasidenib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)

• omaveloxolone
Kalydeco (ivacaftor)

+

omaveloxolone

1 interaction

Caution Advised

ivacaftor + omaveloxolone

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• oxcarbazepine
Kalydeco (ivacaftor)

+

oxcarbazepine

1 interaction

Caution Advised

ivacaftor + oxcarbazepine

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• palovarotene
Kalydeco (ivacaftor)

+

palovarotene

1 interaction

Caution Advised

ivacaftor + palovarotene

caution advised: combo may incr. palovarotene levels, risk of adverse effects (hepatic metabolism inhibited)

• perampanel
Kalydeco (ivacaftor)

+

perampanel

1 interaction

Caution Advised

ivacaftor + perampanel

caution advised if on perampanel 12 mg/day: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• pibrentasvir
Kalydeco (ivacaftor)

+

pibrentasvir

1 interaction

Caution Advised

ivacaftor + pibrentasvir

caution advised: combo may incr. pibrentasvir levels, risk of adverse effects (P-gp-mediated transport inhibited)

• pioglitazone
Kalydeco (ivacaftor)

+

pioglitazone

1 interaction

Caution Advised

ivacaftor + pioglitazone

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• prednisone
Kalydeco (ivacaftor)

+

prednisone

1 interaction

Caution Advised

ivacaftor + prednisone

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• roflumilast
Kalydeco (ivacaftor)

+

roflumilast

1 interaction

Caution Advised

ivacaftor + roflumilast

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast topical
Kalydeco (ivacaftor)

+

roflumilast topical

1 interaction

Caution Advised

ivacaftor + roflumilast topical

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• rufinamide
Kalydeco (ivacaftor)

+

rufinamide

1 interaction

Caution Advised

ivacaftor + rufinamide

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• sarilumab
Kalydeco (ivacaftor)

+

sarilumab

1 interaction

Caution Advised

ivacaftor + sarilumab

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism altered; sarilumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)

• sirolimus topical
Kalydeco (ivacaftor)

+

sirolimus topical

1 interaction

Caution Advised

ivacaftor + sirolimus topical

caution advised: combo may incr. sirolimus levels, risk of adverse effects (hepatic metabolism inhibited)

• stiripentol
Kalydeco (ivacaftor)

+

stiripentol

1 interaction

Caution Advised

ivacaftor + stiripentol

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)

• sunvozertinib
Kalydeco (ivacaftor)

+

sunvozertinib

1 interaction

Caution Advised

ivacaftor + sunvozertinib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• suzetrigine
Kalydeco (ivacaftor)

+

suzetrigine

1 interaction

Caution Advised

ivacaftor + suzetrigine

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• tazemetostat
Kalydeco (ivacaftor)

+

tazemetostat

1 interaction

Caution Advised

ivacaftor + tazemetostat

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• tecovirimat
Kalydeco (ivacaftor)

+

tecovirimat

1 interaction

Caution Advised

ivacaftor + tecovirimat

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• telotristat ethyl
Kalydeco (ivacaftor)

+

telotristat ethyl

1 interaction

Caution Advised

ivacaftor + telotristat ethyl

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• tocilizumab
Kalydeco (ivacaftor)

+

tocilizumab

1 interaction

Caution Advised

ivacaftor + tocilizumab

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism altered; tocilizumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes)

• topiramate
Kalydeco (ivacaftor)

+

topiramate

1 interaction

Caution Advised

ivacaftor + topiramate

caution advised, especially w/ topiramate doses >200 mg/day: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• tovorafenib
Kalydeco (ivacaftor)

+

tovorafenib

1 interaction

Caution Advised

ivacaftor + tovorafenib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• vaborbactam
Kalydeco (ivacaftor)

+

vaborbactam

1 interaction

Caution Advised

ivacaftor + vaborbactam

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)

• vamorolone
Kalydeco (ivacaftor)

+

vamorolone

1 interaction

Caution Advised

ivacaftor + vamorolone

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)

• vemurafenib
Kalydeco (ivacaftor)

+

vemurafenib

1 interaction

Caution Advised

ivacaftor + vemurafenib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism induced)

• vorasidenib
Kalydeco (ivacaftor)

+

vorasidenib

1 interaction

Caution Advised

ivacaftor + vorasidenib

caution advised: combo may decr. ivacaftor levels, efficacy (hepatic metabolism possibly induced)