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Sensitivity of ivacaftor to drug‐drug interactions with rifampin, a cytochrome P450 3A4 inducer
Author(s) -
Guimbellot Jennifer S.,
Acosta Edward P.,
Rowe Steven M.
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23971
Subject(s) - ivacaftor , medicine , cystic fibrosis , drug , pharmacology , exacerbation , drug interaction , cyp3a4 , adverse effect , potentiator , cytochrome p450 , cystic fibrosis transmembrane conductance regulator , metabolism
The CFTR potentiator ivacaftor is responsible for significant clinical improvements among a subset of patients with cystic fibrosis. Because it is a substrate of the cytochrome P450 system, specifically CYP3A4/5, ivacaftor is subject to significant drug‐drug interactions, including due to commonly used antimicrobials such as rifampin. While the interaction of rifampin and ivacaftor has been examined in vitro, severe adverse events resulting from this interaction have not been reported in the literature. In this report, we describe the termination of steady, long‐term improvement in a patient taking ivacaftor, resulting from the use of rifampin and precipitating a significant pulmonary exacerbation.