ivacaftor (Oral route)

eye-va-KAF-tor

Commonly used brand name(s)

In the U.S.

  • Kalydeco

Available Dosage Forms:

  • Tablet

Therapeutic Class: Respiratory Agent

Uses For ivacaftor

Ivacaftor is used to treat cystic fibrosis (CF) in patients 6 years of age and older. It is only used for patients who have the following mutations in the CF gene: G551D, G1244E, G1349D, G178R, G551S, S1251N, S1255P, S549N, or S549R mutations. Your doctor will use a test to check for the mutation before you receive the medicine. ivacaftor works by moving more chloride into the cells of your body. It is a cystic fibrosis transmembrane conductance (CFTR) potentiator.

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ivacaftor is available only with your doctor's prescription.

Before Using ivacaftor

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ivacaftor, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ivacaftor or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ivacaftor in children. However, safety and efficacy have not been established in children younger than 6 years of age.

Geriatric

Although appropriate studies on the relationship of age to the effects of ivacaftor have not been performed in the geriatric population, no geriatric-specific problems have been documented to date.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ivacaftor, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ivacaftor with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Boceprevir
  • Carbamazepine
  • Ceritinib
  • Clarithromycin
  • Conivaptan
  • Dabigatran Etexilate
  • Fosphenytoin
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lopinavir
  • Morphine
  • Morphine Sulfate Liposome
  • Nefazodone
  • Nelfinavir
  • Phenobarbital
  • Phenytoin
  • Posaconazole
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Saquinavir
  • Siltuximab
  • St John's Wort
  • Telaprevir
  • Telithromycin
  • Topotecan
  • Voriconazole

Using ivacaftor with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Fluconazole
  • Midazolam

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of ivacaftor. Make sure you tell your doctor if you have any other medical problems, especially:

  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of ivacaftor

Take ivacaftor exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

ivacaftor comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

Take ivacaftor with fat-containing foods such as butter, cheese pizza, eggs, or peanut butter.

Dosing

The dose of ivacaftor will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ivacaftor. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For cystic fibrosis:
      • Adults and children 6 years of age and older—150 milligrams (mg) every 12 hours, taken with fat-containing food.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of ivacaftor, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using ivacaftor

It is very important that your doctor check the progress of you or your child at regular visits to make sure that ivacaftor is working properly. Blood tests will be needed to check for unwanted effects.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

ivacaftor may make you dizzy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

Do not eat grapefruit or drink grapefruit juice while you are using ivacaftor. Grapefruit and grapefruit juice may cause the amount of medicine in the blood to be too high.

Do not eat Seville oranges (bitter or sour oranges) or drink Seville orange juice while taking ivacaftor. Seville oranges or juice may cause the amount of medicine in the blood to be too high.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

ivacaftor Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Body aches or pain
  • chest pain
  • chills
  • cough
  • difficulty with breathing or troubled breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat
  • unusual tiredness or weakness
Less common
  • Dark urine
  • fever with or without chills
  • light-colored stools
  • loss of appetite
  • nausea and vomiting
  • stomach pain
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Blemishes on the skin
  • diarrhea
  • difficulty with moving
  • dizziness
  • muscle aches
  • muscle pain or stiffness
  • pain in the joints
  • pimples
  • rash

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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