DRUG INTERACTIONS WITH TRIKAFTA® (elexacaftor/tezacaftor/ivacaftor and ivacaftor)

Drug-drug interactions tool

The Drug-Drug Interactions (DDI) Tool provides the established or predicted effect of TRIKAFTA on other medicinal products or effect of other medicinal products on TRIKAFTA1-4
 

  • The clinical comments are based on drug interaction studies, clinical relevance, or predicted interactions due to elimination pathways
  • Drugs shown within a therapeutic class do not represent all possible drugs within the class. Drugs within a therapeutic class may have different metabolic profiles and, therefore, clinical recommendations apply only to the indicated drugs and not the class. The table does not represent all possible drugs or drug classes that a patient could be receiving. For further information, contact your clinical pharmacist

Choose or begin typing the brand or generic drug name or drug class to learn more about potential DDIs

Choose or begin typing the brand or generic drug name or drug class to learn more about potential DDIs

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Drug names in the table that are bold are listed in the full Prescribing Information for SYMDEKO.

Drug names in the table that are bold are listed in the full Prescribing Information for TRIKAFTA.

Drug interaction profiles1

Clinical considerations for TRIKAFTA are based on drug interaction studies, modeling, other clinical factors, and/or predicted interactions due to elimination pathways. Dosage adjustments are required for concomitant use with strong and moderate CYP3A inhibitors.

 

Drug interaction profiles and dose adjustments

Strong CYP3A inducers including: Rifampin, Rifabutin, Phenobarbital, Carbamazepine, Phenytoin, St. John’s wort, (Hypericum perforatum)

Dose recomendation

TRIKAFTA interaction

CONCOMITANT USE
NOT RECOMMENDED

 

Reduced exposure of TRIKAFTA expected with strong CYP3A inducers

  • The concomitant use of CYP3A inducers may reduce TRIKAFTA efficacy

Strong CYP3A inhibitors including: ketoconazole, itraconazole, posaconazole, voriconazole, telithromycin, clarithromycin

Dose recomendation

TRIKAFTA interaction

IN THE MORNING
(TWICE A WEEK)

Two 100mg tablets Day 1

elexacaftor 100 mg/
tezacaftor 50 mg/
ivacaftor 75 mg
2 tablets

NO TABLET IN
THE EVENING

Two 100mg tablets Day 4

elexacaftor 100 mg/
tezacaftor 50 mg/
ivacaftor 75 mg
2 tablets

NO TABLET IN
THE EVENING

 

Increased exposure of TRIKAFTA expected with strong or moderate CYP3A inhibitors

Tablets are not actual size.

Moderate CYP3A inhibitors including: fluconazole, erythromycin

Dose recomendation

TRIKAFTA interaction

ALTERNATE TABLETS
EVERY MORNING

Two 100mg tablets Day 1

elexacaftor 100 mg/
tezacaftor 50 mg/
ivacaftor 75 mg
2 tablets

NO TABLET IN
THE EVENING

150mg tablet Day 2

ivacaftor 150 mg
1 tablet

NO TABLET IN
THE EVENING

 

Increased exposure of TRIKAFTA expected with strong or moderate CYP3A inhibitors

Tablets are not actual size.

CYP2C9 substrates warfarin, glimepiride, glipizide

P-glycoprotein (P-gp) substrates digoxin, cyclosporine, everolimus, sirolimus, tacrolimus

OATP1B1 and OATP1B3 substrates statins (atorvastatin, cerivastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin) glyburide, nateglinide, repaglinide

Dose recomendation

TRIKAFTA interaction

Caution and appropriate monitoring should be used with CYP2C9, P-gp, and OATP1B1 and OATP1B3 substrates

 

Increased exposure of substrates may occur with TRIKAFTA

  • Ivacaftor may inhibit CYP2C9
  • Ivacaftor or tezacaftor/ivacaftor increases digoxin exposure and may increase exposure of other sensitive P-gp substrates
  • Elexacaftor and M23-ELX inhibit OATP1B1 and OATP1B3. Tezacaftor/ivacaftor increases pitavastatin exposure
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