Drug interactions
Ivacaftor + Tacrolimus
Severity: Moderate
Ivacaftor and Tacrolimus: 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 weakly inhibit P-glycoprotein and may increase exposure to tacrolimus. Because tacrolimus has a narrow therapeutic index, even modest increases can matter.
What this interaction means in plain words
Ivacaftor and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Weak P-glycoprotein inhibition by ivacaftor increases tacrolimus absorption.
What to do
Monitor tacrolimus trough levels after starting or stopping ivacaftor and adjust the dose accordingly. Watch renal function and neurological symptoms.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus 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 Tacrolimus?
MediHelp rates the interaction as moderate. Ivacaftor and Tacrolimus 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 weakly inhibit P-glycoprotein and may increase exposure to tacrolimus. Because tacrolimus has a narrow therapeutic index, even modest increases can matter.
How serious is the interaction between Ivacaftor and Tacrolimus?
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 tacrolimus trough levels after starting or stopping ivacaftor and adjust the dose accordingly. Watch renal function and neurological symptoms.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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