Drug Interactions between ivacaftor / lumacaftor and sirolimus

Grapefruit and grapefruit juice may interact with sirolimus and could lead to potentially dangerous effects. Avoid eating grapefruit or drinking grapefruit juice while you are taking sirolimus. Also, you should preferably take sirolimus at least one hour before eating. If you do take it with food, you should take it each time with food to avoid changes in sirolimus levels. The oral liquid form of sirolimus must be mixed with water or orange juice only. Do not use grapefruit juice to mix this medication.

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Ivacaftor should be taken with fat-containing foods such as eggs, avocados, nuts, meat, butter, peanut butter, cheese pizza, and whole-milk dairy products to help with its absorption. Do not consume grapefruit juice or any food that contains grapefruit or Seville oranges during treatment with ivacaftor unless directed otherwise by your doctor. Grapefruit juice can significantly increase the blood levels of ivacaftor. This may increase the risk and/or severity of serious side effects such as liver damage. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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