Cystic Fibrosis Medication Cardiac medication interactions Potential consequence Management strategy Severity
Antibiotics
Antibiotics
Antibiotics
Antibiotics
Antibiotics
Meropenem with varborbactam
Metoprolol Increases the concentration Monitor for toxicity U
Ceftazidime with avibactam
No interaction listed No interaction listed No interaction listed No interaction listed
Cefoxitin
No interaction listed No interaction listed No interaction listed No interaction listed
Tobramycin
Digoxin Increases the concentration Regular monitoring and dose adjustment recommended
+
Furosemide & Torasemide increases the risk of nephrotoxicity and ototoxicity Advised to avoid
++
Colistimethate Sodium (Colomycin)
No interaction listed No interaction listed No interaction listed No interaction listed
Piperacillin with tazobactam (Tazocin)
Warfarin Alters the anti-coagulant effect of warfarin Regular INR monitoring & dose adjustment advised
+++
Azithromycin
Apixaban, Dabigatran & Edoxaban Predicted to increase the exposure No recommendation given
++
Digoxin Increases concentration Advised to monitor digoxin levels
+++
Nadolol Predicted to increase exposure No recommendation given
++
Ticagrelor Increases the exposure Advised to use with caution or avoid
+++
Minocycline
Pravastatin, Rosuvastatin & Simvastatin Increased risk of hepatotoxicity Advised to use with caution
U
Warfarin Increases the anti-coagulant effect of Warfarin Advised to monitor INR
+++
Aztreonam
No interaction listed No interaction listed No interaction listed No interaction listed
Bronchodilators
Bronchodilators
Bronchodilators
Bronchodilators
Bronchodilators
Salbutamol
Bendroflumethiazide, Bumetanide, Chlortalidone, Furosemide, Indapamide, Metolazone, Torasemide Increases the risk of hypokalaemia No recommendation given
U
Digoxin Increases the risk of digoxin toxicity Advised to use with caution
+++
Dronedarone, Flecainide, Quinine, Ranolazine, Sotalol Predicted to cause hypokalaemia (potentially increasing the risk of torsade de pointes) No recommendation given
+++
CFTR Modulators CFTR Modulators CFTR Modulators CFTR Modulators CFTR Modulators
Ivacaftor
Dabigatran, Edoxaban & Rivaroxaban Predicated to increase the exposure Advised to use with caution
++
Digoxin Slightly increases the exposure Advised to use with caution
++
Dronedarone Increases exposure of Ivacaftor Advised to use with caution
++
Verapamil Increases the exposure of Ivacaftor Dose adjustment recommended
++
Warfarin Increases exposure Advised to monitor INR
++
Ivacaftor with tezacaftor and Elexacaftor (Kaftrio)
All interactions included above for Ivacaftor All interactions included above for Ivacaftor All interactions included above for Ivacaftor All interactions included above for Ivacaftor
Atorvastatin, Pravastatin, Rosuvastatin & Simvastatin Increases exposure Advised to use with caution
++
Diltiazem Increases exposure Advised to use with caution
+++
Enzymes
Enzymes
Enzymes
Enzymes
Enzymes
Dornase Alfa
No interaction listed No interaction listed No interaction listed No interaction listed
Steroids Steroids Steroids Steroids Steroids
Prednisolone
Amiodarone & Dronedarone Predicted to cause hypokalaemia & increases the risk of torsade de pointes. No recommendation given
+++
Aspirin Increases concentration & risk of gastrointestinal bleeding No recommendation given
++
Bumetanide, Chlorothiazide, Chlortalidone, Furosemide, Indapamide, Metolazone & Torasemide Increases the risk of hypokalaemia Advised to use with caution U
Digoxin Increases the risk of digoxin toxicity Advised to use with caution
+++
Nicorandil Increases the risk of gastrointestinal perforation Advised to use with caution
+++
Ranolazine Predicted to cause hypokalaemia & increases the risk of torsade de pointes Advised to use with caution
+++
Warfarin Increases the effects of Warfarin Advised to monitor INR
++