Drug interactions
Ivacaftor + Sirolimus
Severity: Moderate
Ivacaftor and Sirolimus: 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
Ivacaftor and its metabolite may inhibit P-gp and weakly inhibit CYP3A4, which can raise sirolimus concentrations. Given the narrow therapeutic index of sirolimus, toxicity may occur.
What this interaction means in plain words
Ivacaftor and Sirolimus 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.
Ivacaftor belongs to Miscellaneous; Sirolimus belongs to Miscellaneous.
Why it happens
Inhibition of P-glycoprotein (and weak CYP3A inhibition) by ivacaftor raises sirolimus exposure.
What to do
Monitor sirolimus trough levels when ivacaftor is started, stopped or changed and adjust the sirolimus dose as needed.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus 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 Ivacaftor with Sirolimus?
MediHelp rates the interaction as moderate. Ivacaftor and Sirolimus 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. Ivacaftor and its metabolite may inhibit P-gp and weakly inhibit CYP3A4, which can raise sirolimus concentrations. Given the narrow therapeutic index of sirolimus, toxicity may occur.
How serious is the interaction between Ivacaftor and Sirolimus?
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 sirolimus trough levels when ivacaftor is started, stopped or changed and adjust the sirolimus dose as needed.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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