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Drug Interactions between ensartinib and ivacaftor / lumacaftor

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

ivacaftor ensartinib

Applies to: ivacaftor / lumacaftor and ensartinib

GENERALLY AVOID: Coadministration with moderate to potent inhibitors of CYP450 3A4 and/or inhibitors of P-glycoprotein (P-gp) efflux transporter system may increase the plasma concentrations of ensartinib, which is a substrate of both the isoenzyme and efflux transporter in vitro. Concomitant use may increase the risk and/or severity of adverse events. Clinical data characterizing the extent of this interaction and data with less potent inhibitors are not available.

MANAGEMENT: Concomitant use of ensartinib with moderate to potent inhibitors of CYP450 3A4 and/or inhibitors of P-gp should generally be avoided. Consultation with package labeling and relevant institutional protocols may be advisable for further guidance.

References (1)
  1. (2024) "Product Information. Ensacove (ensartinib)." Xcovery Holdings, Inc.
Moderate

lumacaftor ensartinib

Applies to: ivacaftor / lumacaftor and ensartinib

GENERALLY AVOID: Coadministration with moderate to potent inducers of CYP450 3A4 may decrease the plasma concentrations and pharmacologic effects of ensartinib, which is primarily metabolized via the isoenzyme in vitro. Clinical data characterizing the extent of this interaction and data with less potent inducers are not available.

MANAGEMENT: Concomitant use of ensartinib with moderate to potent inducers of CYP450 3A4 should generally be avoided. The possibility of diminished therapeutic effects should be considered. Consultation with package labeling and relevant institutional protocols may be advisable for further guidance.

References (1)
  1. (2024) "Product Information. Ensacove (ensartinib)." Xcovery Holdings, Inc.

Drug and food/lifestyle interactions

Moderate

ivacaftor food/lifestyle

Applies to: ivacaftor / lumacaftor

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ivacaftor. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Elexacaftor and tezacaftor are also CYP450 3A4 substrates in vitro and may interact similarly with grapefruit juice, whereas lumacaftor is not expected to interact.

ADJUST DOSING INTERVAL: According to prescribing information, systemic exposure to ivacaftor increased approximately 2.5- to 4-fold, systemic exposure to elexacaftor increased approximately 1.9- to 2.5-fold, and systemic exposure to lumacaftor increased approximately 2-fold following administration with fat-containing foods relative to administration in a fasting state. Tezacaftor exposure is not significantly affected by administration of fat-containing foods.

MANAGEMENT: Patients treated with ivacaftor-containing medications should avoid consumption of grapefruit juice and any food that contains grapefruit or Seville oranges. All ivacaftor-containing medications should be administered with fat-containing foods such as eggs, avocados, nuts, meat, butter, peanut butter, cheese pizza, and whole-milk dairy products. A typical cystic fibrosis diet will satisfy this requirement.

References (4)
  1. (2012) "Product Information. Kalydeco (ivacaftor)." Vertex Pharmaceuticals
  2. (2015) "Product Information. Orkambi (ivacaftor-lumacaftor)." Vertex Pharmaceuticals
  3. (2022) "Product Information. Symdeko (ivacaftor-tezacaftor)." Vertex Pharmaceuticals
  4. (2019) "Product Information. Trikafta (elexacaftor/ivacaftor/tezacaftor)." Vertex Pharmaceuticals

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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