Drug interactions
Cyclosporin + Ivacaftor
Severity: Moderate
Cyclosporin and Ivacaftor: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cyclosporin inhibits CYP3A4 and may raise ivacaftor exposure, while ivacaftor may inhibit P-glycoprotein and increase cyclosporin concentrations. Because cyclosporin has a narrow therapeutic index, higher levels could cause nephrotoxicity or other toxicity.
What this interaction means in plain words
Cyclosporin and Ivacaftor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cyclosporin belongs to Miscellaneous; Ivacaftor belongs to Miscellaneous.
Why it happens
Cyclosporin inhibits CYP3A4 metabolism of ivacaftor, and ivacaftor weakly inhibits P-glycoprotein efflux of cyclosporin.
What to do
Monitor cyclosporin trough concentrations and renal function after starting or stopping ivacaftor, adjusting the cyclosporin dose as needed. Reduce ivacaftor dosing according to product labeling for use with CYP3A inhibitors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
Other interactions of Ivacaftor
- Ensitrelvir + Ivacaftor Contraindicated
- Apalutamide + Ivacaftor Major
- Carbamazepine + Ivacaftor Major
- Clarithromycin + Ivacaftor Major
- Efavirenz + Ivacaftor Major
- Enzalutamide + Ivacaftor Major
Frequently asked questions
Can I take Cyclosporin with Ivacaftor?
MediHelp rates the interaction as moderate. Cyclosporin and Ivacaftor can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cyclosporin inhibits CYP3A4 and may raise ivacaftor exposure, while ivacaftor may inhibit P-glycoprotein and increase cyclosporin concentrations. Because cyclosporin has a narrow therapeutic index, higher levels could cause nephrotoxicity or other toxicity.
How serious is the interaction between Cyclosporin and Ivacaftor?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporin trough concentrations and renal function after starting or stopping ivacaftor, adjusting the cyclosporin dose as needed. Reduce ivacaftor dosing according to product labeling for use with CYP3A inhibitors.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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