Drug interactions
Erythromycin + Ivacaftor
Severity: Moderate
Erythromycin 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
Erythromycin, a moderate CYP3A4 inhibitor, increases ivacaftor exposure, which may increase ivacaftor-related adverse effects such as transaminase elevation, headache and dizziness. Ivacaftor may also weakly inhibit P-glycoprotein and modestly raise erythromycin levels.
What this interaction means in plain words
Erythromycin 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.
Erythromycin belongs to Anti Bacterial; Ivacaftor belongs to Miscellaneous.
Why it happens
Erythromycin inhibits CYP3A4-mediated ivacaftor metabolism, and ivacaftor may inhibit P-glycoprotein efflux of erythromycin.
What to do
Reduce the ivacaftor dose according to the product labeling for moderate CYP3A4 inhibitors and monitor liver enzymes and tolerability.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin 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 Erythromycin with Ivacaftor?
MediHelp rates the interaction as moderate. Erythromycin 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. Erythromycin, a moderate CYP3A4 inhibitor, increases ivacaftor exposure, which may increase ivacaftor-related adverse effects such as transaminase elevation, headache and dizziness. Ivacaftor may also weakly inhibit P-glycoprotein and modestly raise erythromycin levels.
How serious is the interaction between Erythromycin 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: Reduce the ivacaftor dose according to the product labeling for moderate CYP3A4 inhibitors and monitor liver enzymes and tolerability.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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