Consider an alternative to these antibiotics, such as ciprofloxacin, azithromycin, and levofloxacin. 7.15 Concomitant Drugs That Do Not Need Dosage Adjustment No dosage adjustment of ORKAMBI or concomitant drug is recommended when ORKAMBI is given with the following: azithromycin, aztreonam, budesonide, ceftazidime, cetirizine, ciprofloxacin, colistimethate, colistin, dornase alfa, fluticasone, ipratropium, levofloxacin, pancreatin, pancrelipase, salbutamol, salmeterol, sulfamethoxazole, trimethoprim, tiotropium, and tobramycin.
Source: FDA drug label - lumacaftor and ivacaftor
Consider an alternative to these antibiotics, such as ciprofloxacin, azithromycin, and levofloxacin. 7.15 Concomitant Drugs That Do Not Need Dosage Adjustment No dosage adjustment of ORKAMBI or concomitant drug is recommended when ORKAMBI is given with the following: azithromycin, aztreonam, budesonide, ceftazidime, cetirizine, ciprofloxacin, colistimethate, colistin, dornase alfa, fluticasone, ipratropium, levofloxacin, pancreatin, pancrelipase, salbutamol, salmeterol, sulfamethoxazole, trimethoprim, tiotropium, and tobramycin.
Source: FDA drug label - lumacaftor and ivacaftor
telithromycin, clarithromycin. 7.7 Antibiotics Concomitant use of ORKAMBI may decrease the exposure of clarithromycin, erythromycin, and telithromycin, which may reduce the effectiveness of these antibiotics.
Source: FDA drug label - lumacaftor and ivacaftor
7.7 Antibiotics Concomitant use of ORKAMBI may decrease the exposure of clarithromycin, erythromycin, and telithromycin, which may reduce the effectiveness of these antibiotics.
Source: FDA drug label - lumacaftor and ivacaftor
7.13 Proton Pump Inhibitors, H 2 Blockers, Antacids ORKAMBI may reduce the exposure and effectiveness of proton pump inhibitors such as omeprazole, esomeprazole, and lansoprazole, and may alter the exposure of ranitidine.
Source: FDA drug label - lumacaftor and ivacaftor
Consider an alternative such as fluconazole.
Source: FDA drug label - lumacaftor and ivacaftor
( 2.3 , 7 , 12.3 ) Potential for Other Drugs to Affect Lumacaftor/Ivacaftor 7.1 Inhibitors of CYP3A Co-administration of lumacaftor/ivacaftor with itraconazole, a strong CYP3A inhibitor, did not impact the exposure of lumacaftor, but increased ivacaftor exposure by 4.3-fold. Examples of strong CYP3A inhibitors include: ketoconazole, itraconazole, posaconazole, and voriconazole. 7.8 Antifungals Concomitant use of ORKAMBI may reduce the exposure and effectiveness of itraconazole, ketoconazole, posaconazole, and voriconazole.
Source: FDA drug label - lumacaftor and ivacaftor
Examples of strong CYP3A inhibitors include: ketoconazole, itraconazole, posaconazole, and voriconazole. 7.8 Antifungals Concomitant use of ORKAMBI may reduce the exposure and effectiveness of itraconazole, ketoconazole, posaconazole, and voriconazole.
Source: FDA drug label - lumacaftor and ivacaftor
7.13 Proton Pump Inhibitors, H 2 Blockers, Antacids ORKAMBI may reduce the exposure and effectiveness of proton pump inhibitors such as omeprazole, esomeprazole, and lansoprazole, and may alter the exposure of ranitidine.
Source: FDA drug label - lumacaftor and ivacaftor
Consider an alternative to these antibiotics, such as ciprofloxacin, azithromycin, and levofloxacin. 7.15 Concomitant Drugs That Do Not Need Dosage Adjustment No dosage adjustment of ORKAMBI or concomitant drug is recommended when ORKAMBI is given with the following: azithromycin, aztreonam, budesonide, ceftazidime, cetirizine, ciprofloxacin, colistimethate, colistin, dornase alfa, fluticasone, ipratropium, levofloxacin, pancreatin, pancrelipase, salbutamol, salmeterol, sulfamethoxazole, trimethoprim, tiotropium, and tobramycin.
Source: FDA drug label - lumacaftor and ivacaftor
Concomitant use of ORKAMBI may reduce the exposure and effectiveness of prednisone and methylprednisolone.
Source: FDA drug label - lumacaftor and ivacaftor
Co-administration of ORKAMBI is not recommended with sensitive CYP3A substrates or CYP3A substrates with a narrow therapeutic index [see Warnings and Precautions (5.8) and Clinical Pharmacology (12.3) ] such as: Benzodiazepines : midazolam, triazolam (consider an alternative to these benzodiazepines).
Source: FDA drug label - lumacaftor and ivacaftor
7.13 Proton Pump Inhibitors, H 2 Blockers, Antacids ORKAMBI may reduce the exposure and effectiveness of proton pump inhibitors such as omeprazole, esomeprazole, and lansoprazole, and may alter the exposure of ranitidine.
Source: FDA drug label - lumacaftor and ivacaftor
Examples of strong CYP3A inhibitors include: ketoconazole, itraconazole, posaconazole, and voriconazole. 7.8 Antifungals Concomitant use of ORKAMBI may reduce the exposure and effectiveness of itraconazole, ketoconazole, posaconazole, and voriconazole.
Source: FDA drug label - lumacaftor and ivacaftor
7.15 Concomitant Drugs That Do Not Need Dosage Adjustment No dosage adjustment of ORKAMBI or concomitant drug is recommended when ORKAMBI is given with the following: azithromycin, aztreonam, budesonide, ceftazidime, cetirizine, ciprofloxacin, colistimethate, colistin, dornase alfa, fluticasone, ipratropium, levofloxacin, pancreatin, pancrelipase, salbutamol, salmeterol, sulfamethoxazole, trimethoprim, tiotropium, and tobramycin.
Source: FDA drug label - lumacaftor and ivacaftor
telithromycin, clarithromycin. 7.7 Antibiotics Concomitant use of ORKAMBI may decrease the exposure of clarithromycin, erythromycin, and telithromycin, which may reduce the effectiveness of these antibiotics.
Source: FDA drug label - lumacaftor and ivacaftor
7.15 Concomitant Drugs That Do Not Need Dosage Adjustment No dosage adjustment of ORKAMBI or concomitant drug is recommended when ORKAMBI is given with the following: azithromycin, aztreonam, budesonide, ceftazidime, cetirizine, ciprofloxacin, colistimethate, colistin, dornase alfa, fluticasone, ipratropium, levofloxacin, pancreatin, pancrelipase, salbutamol, salmeterol, sulfamethoxazole, trimethoprim, tiotropium, and tobramycin.
Source: FDA drug label - lumacaftor and ivacaftor
Co-administration of ORKAMBI is not recommended with sensitive CYP3A substrates or CYP3A substrates with a narrow therapeutic index [see Warnings and Precautions (5.8) and Clinical Pharmacology (12.3) ] such as: Benzodiazepines : midazolam, triazolam (consider an alternative to these benzodiazepines).
Source: FDA drug label - lumacaftor and ivacaftor
Examples of strong CYP3A inhibitors include: ketoconazole, itraconazole, posaconazole, and voriconazole. 7.8 Antifungals Concomitant use of ORKAMBI may reduce the exposure and effectiveness of itraconazole, ketoconazole, posaconazole, and voriconazole.
Source: FDA drug label - lumacaftor and ivacaftor