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

Drug-drug interactions tool

Previously the Drug Interaction Tool for TRIKAFTA located on this website classified clofazimine as a weak CYP3A4 inhibitor and stated that no dosage adjustment for TRIKAFTA was required. There are insufficient data available to classify the degree of CYP3A inhibition produced by clofazimine.

Please see the table below and refer to the US Prescribing Information for recommended dosage of TRIKAFTA and recommended dose adjustments for use with CYP3A inducers and inhibitors.


For more information about this and other drug interactions, please contact Vertex Medical Information at +1-877-634-8789 or medicalinfo@vrtx.com.

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 TRIKAFTA.1-4

 

  • 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 profiles and related dosing considerations1

 

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 recommendation

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 recommendation

TRIKAFTA interaction
The dosage of TRIKAFTA should be reduced when co‑administered with strong CYP3A inhibitors. For full dosing table, including dose adjustments, click here
 

Increased exposure of TRIKAFTA expected with strong or moderate CYP3A inhibitors

Moderate CYP3A inhibitors including: fluconazole, erythromycin

Dose recommendation

TRIKAFTA interaction
The dosage of TRIKAFTA should be reduced when co‑administered with strong CYP3A inhibitors. For full dosing table, including dose adjustments, click here
 

Increased exposure of TRIKAFTA expected with strong or moderate CYP3A inhibitors

CYP2C9 substrates including: warfarin, glimepiride, glipizide

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

OATP1B1 and OATP1B3 substrates including:1,2 statins (atorvastatin, cerivastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin), glyburide, nateglinide, repaglinide

Dose recommendation

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 in vitro
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