Drug interactions
Ivacaftor + Verapamil
Severity: Moderate
Ivacaftor and Verapamil: 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
Verapamil, a moderate CYP3A4 inhibitor, raises ivacaftor exposure, and ivacaftor may inhibit P-gp and increase verapamil exposure. Increased ivacaftor can increase adverse effects such as transaminase elevation.
What this interaction means in plain words
Ivacaftor and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits CYP3A4 metabolism of ivacaftor, while ivacaftor inhibits P-glycoprotein efflux of verapamil.
What to do
Reduce the ivacaftor dose per product labeling for moderate CYP3A inhibitors and monitor liver enzymes. Monitor blood pressure and heart rate for increased verapamil effect.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
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 Verapamil?
MediHelp rates the interaction as moderate. Ivacaftor and Verapamil 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. Verapamil, a moderate CYP3A4 inhibitor, raises ivacaftor exposure, and ivacaftor may inhibit P-gp and increase verapamil exposure. Increased ivacaftor can increase adverse effects such as transaminase elevation.
How serious is the interaction between Ivacaftor and Verapamil?
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 per product labeling for moderate CYP3A inhibitors and monitor liver enzymes. Monitor blood pressure and heart rate for increased verapamil effect.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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