Drug interactions
Lumacaftor / ivacaftor + Sirolimus
Severity: Major
Lumacaftor / ivacaftor and Sirolimus: 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 sirolimus levels, risking loss of immunosuppression and rejection or disease control failure. Ivacaftor may weakly inhibit CYP3A and P-glycoprotein, so net effects can be unpredictable.
What this interaction means in plain words
Lumacaftor / ivacaftor and Sirolimus 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 CYP3A4 (and possibly P-glycoprotein) by lumacaftor increases sirolimus clearance.
What to do
Avoid if possible. If needed, monitor sirolimus trough concentrations frequently and adjust the dose, and recheck after the CFTR modulator is stopped.
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 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
Frequently asked questions
Can I take Lumacaftor / ivacaftor with Sirolimus?
MediHelp rates the interaction as major. Lumacaftor / ivacaftor and Sirolimus 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 sirolimus levels, risking loss of immunosuppression and rejection or disease control failure. Ivacaftor may weakly inhibit CYP3A and P-glycoprotein, so net effects can be unpredictable.
How serious is the interaction between Lumacaftor / ivacaftor and Sirolimus?
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 if possible. If needed, monitor sirolimus trough concentrations frequently and adjust the dose, and recheck after the CFTR modulator is stopped.
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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