Drug interactions
Cyclosporin + Lumacaftor / ivacaftor
Severity: Major
Cyclosporin and Lumacaftor / ivacaftor: major 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
Lumacaftor is a strong CYP3A inducer and can lower cyclosporine exposure substantially. This may cause loss of immunosuppression and a risk of graft rejection. Ivacaftor, a weak CYP3A and P-gp inhibitor, adds little offsetting effect.
What this interaction means in plain words
Cyclosporin and Lumacaftor / ivacaftor can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Induction of CYP3A (and possibly P-gp) by lumacaftor increases cyclosporine clearance.
What to do
Avoid the combination where possible. If it is needed, monitor cyclosporine trough levels closely and increase the dose as required.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Frequently asked questions
Can I take Cyclosporin with Lumacaftor / ivacaftor?
MediHelp rates the interaction as major. Cyclosporin and Lumacaftor / ivacaftor can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Lumacaftor is a strong CYP3A inducer and can lower cyclosporine exposure substantially. This may cause loss of immunosuppression and a risk of graft rejection. Ivacaftor, a weak CYP3A and P-gp inhibitor, adds little offsetting effect.
How serious is the interaction between Cyclosporin and Lumacaftor / ivacaftor?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If it is needed, monitor cyclosporine trough levels closely and increase the dose as required.
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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