Drug interactions
Lumacaftor / ivacaftor + Warfarin
Severity: Moderate
Lumacaftor / ivacaftor and Warfarin: 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
Lumacaftor is a strong CYP3A inducer and may also induce other enzymes involved in warfarin metabolism, which can lower warfarin exposure and the INR. Reduced anticoagulation raises the risk of thromboembolism.
What this interaction means in plain words
Lumacaftor / ivacaftor and Warfarin 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.
Why it happens
Induction of CYP3A4 and other enzymes (including CYP2C9) by lumacaftor increases warfarin clearance.
What to do
Monitor INR closely when starting or stopping lumacaftor/ivacaftor and increase the warfarin dose if the INR falls below the target.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Lumacaftor / ivacaftor with Warfarin?
MediHelp rates the interaction as moderate. Lumacaftor / ivacaftor and Warfarin 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. Lumacaftor is a strong CYP3A inducer and may also induce other enzymes involved in warfarin metabolism, which can lower warfarin exposure and the INR. Reduced anticoagulation raises the risk of thromboembolism.
How serious is the interaction between Lumacaftor / ivacaftor and Warfarin?
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 INR closely when starting or stopping lumacaftor/ivacaftor and increase the warfarin dose if the INR falls below the target.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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