itraconazole oral brand names and other generic formulations include:
Onmel Oral, Sporanox Oral, Sporanox Pulsepak Oral
lumacaftor-ivacaftor oral brand names and other generic formulations include:
Orkambi Oral
itraconazole oral and lumacaftor-ivacaftor oral
itraconazole oral increases levels of lumacaftor-ivacaftor oral by altering drug metabolism. Combination increases blood levels of ivacaftor.
itraconazole oral and lumacaftor-ivacaftor oral
itraconazole oral increases levels of lumacaftor-ivacaftor oral by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Strong CYP3A inhibitors do not impact lumacaftor exposure, but increased ivacaftor exposure by 4.3-fold. Due to the induction effect of lumacaftor on CYP3A, at steady-state the net exposure of ivacaftor is not expected to exceed that when given in the absence of lumacaftor at a dose of 150 mg q12hr (the approved dose of ivacaftor monotherapy). Therefore, no dose adjustment is necessary when CYP3A inhibitors are initiated in patients currently taking lumacaftor/ivacaftor. However, when initiating lumacaftor/ivacaftor in patients taking strong CYP3A inhibitors, reduce the dose to 1 tablet daily (lumacaftor 200 mg/ivacaftor 125 mg total daily dose) for the first week of treatment to allow for the steady-state induction effect of lumacaftor. Following this period, continue with the recommended daily dose. No dose adjustment is required for moderate or weak CYP3A4 inhibitors.
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Drug Interaction Categories
Contraindicated
Never use this combination of drugs because of high risk for dangerous interaction
Serious
Potential for serious interaction; regular monitoring by your doctor required or alternate medication may be needed
Significant
Potential for significant interaction (monitoring by your doctor is likely required)
Minor
Interaction is unlikely, minor, or nonsignificant