Details of the Drug

General Information of Drug (ID: DMZC1HS)

• Drug Name: Ivacaftor
• Synonyms: Kalydeco (TN)

Indication

Disease Entry	ICD 11	Status	REF
Cystic fibrosis	CA25	Approved	[1]

• Affected Organisms: Humans and other mammals
• ATC Code:
  R07AX02: Ivacaftor
  R07AX: Other respiratory system products
  R07A: OTHER RESPIRATORY SYSTEM PRODUCTS
  R07: OTHER RESPIRATORY SYSTEM PRODUCTS
  R: RESPIRATORY SYSTEM
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 1:
  Molecular Weight (mw); 392.5
  Logarithm of the Partition Coefficient (xlogp); 5.6
  Rotatable Bond Count (rotbonds); 4
  Hydrogen Bond Donor Count (hbonddonor); 3
  Hydrogen Bond Acceptor Count (hbondacc); 4
• ADMET Property:
  Absorption AUC: The area under the plot of plasma concentration (AUC) of drug is 10600 mcgh/L [2]
  Absorption Cmax: The maximum plasma concentration (Cmax) of drug is 768 mcg/L [2]
  Absorption Tmax: The time to maximum plasma concentration (Tmax) is 4 h [2]
  BDDCS Class: Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 2: low solubility and high permeability [3]
  Clearance: The clearance of drug is 17.3 L/h in healthy subjects [4]
  Elimination: After oral administration, ivacaftor is mainly eliminated in the feces after metabolic conversion and this elimination represents 87.8% of the dose [2]
  Half-life: The concentration or amount of drug in body reduced by one-half in 12 hours [4]
  Metabolism: The drug is metabolized via the CYP3A [2]
  Vd: The volume of distribution (Vd) of drug is 353 L [4]
• Chemical Identifiers:
  Formula: C24H28N2O3
  IUPAC Name: N-(2,4-ditert-butyl-5-hydroxyphenyl)-4-oxo-1H-quinoline-3-carboxamide
  Canonical SMILES: CC(C)(C)C1=CC(=C(C=C1NC(=O)C2=CNC3=CC=CC=C3C2=O)O)C(C)(C)C
  InChI: InChI=1S/C24H28N2O3/c1-23(2,3)16-11-17(24(4,5)6)20(27)12-19(16)26-22(29)15-13-25-18-10-8-7-9-14(18)21(15)28/h7-13,27H,1-6H3,(H,25,28)(H,26,29)
  InChIKey: PURKAOJPTOLRMP-UHFFFAOYSA-N
• Cross-matching ID:
  PubChem CID: 16220172
  ChEBI ID: CHEBI:66901
  CAS Number: 873054-44-5
  UNII: 1Y740ILL1Z
  DrugBank ID: DB08820
  TTD ID: D0W7WC
  VARIDT ID: DR00466
  INTEDE ID: DR0898
  ACDINA ID: D00339

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
cAMP-dependent chloride channel (CFTR)	TTRLZHP	CFTR_HUMAN	Modulator	[5]

Drug Transporter (DTP)

DTP Name	DTP ID	UniProt ID	MOA	REF
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[6]

Drug-Metabolizing Enzyme (DME)

DME Name	DME ID	UniProt ID	MOA	REF
Cytochrome P450 3A4 (CYP3A4) Main DME	DE4LYSA	CP3A4_HUMAN	Substrate	[7]
Cytochrome P450 3A5 (CYP3A5)	DEIBDNY	CP3A5_HUMAN	Substrate	[7]

Drug Off-Target (DOT)

DOT Name	DOT ID	UniProt ID	Interaction	REF
Cystic fibrosis transmembrane conductance regulator (CFTR)	OT6B22QH	CFTR_HUMAN	Gene/Protein Processing	[8]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Ivacaftor (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Remdesivir	DMBFZ6L	Moderate	Increased risk of hepatotoxicity by the combination of Ivacaftor and Remdesivir.	1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019]	[9]
Metreleptin	DM1NOEK	Moderate	Increased metabolism of Ivacaftor caused by Metreleptin mediated induction of CYP450 enzyme.	Acute diabete complication [5A2Y]	[10]
Ivosidenib	DM8S6T7	Moderate	Increased metabolism of Ivacaftor caused by Ivosidenib mediated induction of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[10]
Arn-509	DMT81LZ	Major	Increased metabolism of Ivacaftor caused by Arn-509 mediated induction of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[9]
Gilteritinib	DMTI0ZO	Moderate	Decreased metabolism of Ivacaftor caused by Gilteritinib mediated inhibition of CYP450 enzyme.	Acute myeloid leukaemia [2A60]	[11]
Ivabradine	DM0L594	Moderate	Decreased metabolism of Ivacaftor caused by Ivabradine mediated inhibition of CYP450 enzyme.	Angina pectoris [BA40]	[11]
Bedaquiline	DM3906J	Moderate	Increased risk of hepatotoxicity by the combination of Ivacaftor and Bedaquiline.	Antimicrobial drug resistance [MG50-MG52]	[12]
Troleandomycin	DMUZNIG	Major	Decreased metabolism of Ivacaftor caused by Troleandomycin mediated inhibition of CYP450 enzyme.	Bacterial infection [1A00-1C4Z]	[9]
Erdafitinib	DMI782S	Moderate	Increased metabolism of Ivacaftor caused by Erdafitinib mediated induction of CYP450 enzyme.	Bladder cancer [2C94]	[13]
Pexidartinib	DMS2J0Z	Major	Increased risk of hepatotoxicity by the combination of Ivacaftor and Pexidartinib.	Bone/articular cartilage neoplasm [2F7B]	[14]
Talazoparib	DM1KS78	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Talazoparib.	Breast cancer [2C60-2C6Y]	[15]
Tucatinib	DMBESUA	Major	Decreased metabolism of Ivacaftor caused by Tucatinib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[9]
Palbociclib	DMD7L94	Moderate	Decreased metabolism of Ivacaftor caused by Palbociclib mediated inhibition of CYP450 enzyme.	Breast cancer [2C60-2C6Y]	[10]
Macitentan	DMP79A1	Moderate	Decreased metabolism of Ivacaftor caused by Macitentan mediated inhibition of CYP450 enzyme.	Cardiovascular disease [BA00-BE2Z]	[16]
PF-04449913	DMSB068	Moderate	Decreased metabolism of Ivacaftor caused by PF-04449913 mediated inhibition of CYP450 enzyme.	Chronic myelomonocytic leukaemia [2A40]	[17]
Fidaxomicin	DMFP6MV	Minor	Decreased clearance of Ivacaftor due to the transporter inhibition by Fidaxomicin.	Clostridium difficile enterocolitis [1A04]	[9]
Intedanib	DMSTA36	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Intedanib.	Colorectal cancer [2B91]	[18]
Osilodrostat	DMIJC9X	Moderate	Decreased metabolism of Ivacaftor caused by Osilodrostat mediated inhibition of CYP450 enzyme.	Cushing syndrome [5A70]	[10]
MK-8228	DMOB58Q	Major	Decreased metabolism of Ivacaftor caused by MK-8228 mediated inhibition of CYP450 enzyme.	Cytomegaloviral disease [1D82]	[11]
Polatuzumab vedotin	DMF6Y0L	Moderate	Decreased metabolism of Ivacaftor caused by Polatuzumab vedotin mediated inhibition of CYP450 enzyme.	Diffuse large B-cell lymphoma [2A81]	[19]
Stiripentol	DMMSDOY	Moderate	Decreased metabolism of Ivacaftor caused by Stiripentol mediated inhibition of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[11]
Eslicarbazepine	DMZREFQ	Moderate	Increased metabolism of Ivacaftor caused by Eslicarbazepine mediated induction of CYP450 enzyme.	Epilepsy/seizure [8A61-8A6Z]	[10]
Cannabidiol	DM0659E	Moderate	Increased risk of hepatotoxicity by the combination of Ivacaftor and Cannabidiol.	Epileptic encephalopathy [8A62]	[11]
Tazemetostat	DMWP1BH	Moderate	Decreased metabolism of Ivacaftor caused by Tazemetostat mediated inhibition of CYP450 enzyme.	Follicular lymphoma [2A80]	[20]
Mirabegron	DMS1GYT	Minor	Decreased metabolism of Ivacaftor caused by Mirabegron mediated inhibition of CYP450 enzyme.	Functional bladder disorder [GC50]	[21]
Ripretinib	DM958QB	Moderate	Decreased metabolism of Ivacaftor caused by Ripretinib mediated inhibition of CYP450 enzyme.	Gastrointestinal stromal tumour [2B5B]	[9]
Avapritinib	DMK2GZX	Moderate	Decreased metabolism of Ivacaftor caused by Avapritinib mediated inhibition of CYP450 enzyme.	Gastrointestinal stromal tumour [2B5B]	[11]
Boceprevir	DMBSHMF	Major	Decreased metabolism of Ivacaftor caused by Boceprevir mediated inhibition of CYP450 enzyme.	Hepatitis virus infection [1E50-1E51]	[9]
Brentuximab vedotin	DMWLC57	Moderate	Decreased metabolism of Ivacaftor caused by Brentuximab vedotin mediated inhibition of CYP450 enzyme.	Hodgkin lymphoma [2B30]	[22]
MK-1439	DM215WE	Minor	Decreased metabolism of Ivacaftor caused by MK-1439 mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[23]
Cobicistat	DM6L4H2	Major	Decreased metabolism of Ivacaftor caused by Cobicistat mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[9]
Dolutegravir	DMCZGRE	Minor	Decreased metabolism of Ivacaftor caused by Dolutegravir mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[24]
Rilpivirine	DMJ0QOW	Moderate	Decreased metabolism of Ivacaftor caused by Rilpivirine mediated inhibition of CYP450 enzyme.	Human immunodeficiency virus disease [1C60-1C62]	[9]
Teriflunomide	DMQ2FKJ	Major	Increased risk of hepatotoxicity by the combination of Ivacaftor and Teriflunomide.	Hyper-lipoproteinaemia [5C80]	[25]
BMS-201038	DMQTAGO	Major	Increased risk of hepatotoxicity by the combination of Ivacaftor and BMS-201038.	Hyper-lipoproteinaemia [5C80]	[26]
Aliskiren	DM1BV7W	Moderate	Decreased metabolism of Ivacaftor caused by Aliskiren mediated inhibition of CYP450 enzyme.	Hypertension [BA00-BA04]	[25]
Levamlodipine	DM92S6N	Moderate	Decreased metabolism of Ivacaftor caused by Levamlodipine mediated inhibition of CYP450 enzyme.	Hypertension [BA00-BA04]	[10]
Lesinurad	DMUR64T	Moderate	Decreased metabolism of Ivacaftor caused by Lesinurad mediated inhibition of CYP450 enzyme.	Inborn purine/pyrimidine/nucleotide metabolism error [5C55]	[27]
Berotralstat	DMWA2DZ	Major	Decreased clearance of Ivacaftor due to the transporter inhibition by Berotralstat.	Innate/adaptive immunodeficiency [4A00]	[28]
Tasimelteon	DMLOQ1V	Moderate	Decreased metabolism of Ivacaftor caused by Tasimelteon mediated inhibition of CYP450 enzyme.	Insomnia [7A00-7A0Z]	[29]
Naloxegol	DML0B41	Minor	Decreased clearance of Ivacaftor due to the transporter inhibition by Naloxegol.	Large intestine motility disorder [DB32]	[30]
Pemigatinib	DM819JF	Moderate	Decreased metabolism of Ivacaftor caused by Pemigatinib mediated inhibition of CYP450 enzyme.	Liver cancer [2C12]	[11]
Crizotinib	DM4F29C	Major	Decreased metabolism of Ivacaftor caused by Crizotinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[11]
Brigatinib	DM7W94S	Moderate	Decreased metabolism of Ivacaftor caused by Brigatinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[9]
Ceritinib	DMB920Z	Major	Decreased metabolism of Ivacaftor caused by Ceritinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[9]
Lurbinectedin	DMEFRTZ	Moderate	Decreased metabolism of Ivacaftor caused by Lurbinectedin mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[31]
Osimertinib	DMRJLAT	Moderate	Increased metabolism of Ivacaftor caused by Osimertinib mediated induction of CYP450 enzyme.	Lung cancer [2C25]	[11]
Pralsetinib	DMWU0I2	Moderate	Decreased metabolism of Ivacaftor caused by Pralsetinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[32]
Selpercatinib	DMZR15V	Moderate	Decreased metabolism of Ivacaftor caused by Selpercatinib mediated inhibition of CYP450 enzyme.	Lung cancer [2C25]	[10]
Artesunate	DMR27C8	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Artesunate.	Malaria [1F40-1F45]	[10]
Calaspargase pegol	DMQZBXI	Moderate	Increased risk of hepatotoxicity by the combination of Ivacaftor and Calaspargase pegol.	Malignant haematopoietic neoplasm [2B33]	[33]
Idelalisib	DM602WT	Major	Decreased metabolism of Ivacaftor caused by Idelalisib mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[9]
GDC-0199	DMH0QKA	Major	Decreased clearance of Ivacaftor due to the transporter inhibition by GDC-0199.	Mature B-cell leukaemia [2A82]	[9]
IPI-145	DMWA24P	Major	Decreased metabolism of Ivacaftor caused by IPI-145 mediated inhibition of CYP450 enzyme.	Mature B-cell leukaemia [2A82]	[11]
Acalabrutinib	DM7GCVW	Moderate	Decreased metabolism of Ivacaftor caused by Acalabrutinib mediated inhibition of CYP450 enzyme.	Mature B-cell lymphoma [2A85]	[34]
Ibrutinib	DMHZCPO	Moderate	Decreased metabolism of Ivacaftor caused by Ibrutinib mediated inhibition of CYP450 enzyme.	Mature B-cell lymphoma [2A85]	[35]
Arry-162	DM1P6FR	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Arry-162.	Melanoma [2C30]	[9]
Vemurafenib	DM62UG5	Moderate	Increased metabolism of Ivacaftor caused by Vemurafenib mediated induction of CYP450 enzyme.	Melanoma [2C30]	[10]
Selumetinib	DMC7W6R	Moderate	Decreased metabolism of Ivacaftor caused by Selumetinib mediated inhibition of CYP450 enzyme.	Melanoma [2C30]	[36]
LGX818	DMNQXV8	Moderate	Increased metabolism of Ivacaftor caused by LGX818 mediated induction of CYP450 enzyme.	Melanoma [2C30]	[37]
Dabrafenib	DMX6OE3	Moderate	Increased metabolism of Ivacaftor caused by Dabrafenib mediated induction of CYP450 enzyme.	Melanoma [2C30]	[11]
Ubrogepant	DM749I3	Moderate	Decreased metabolism of Ivacaftor caused by Ubrogepant mediated inhibition of CYP450 enzyme.	Migraine [8A80]	[38]
Rimegepant	DMHOAUG	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Rimegepant.	Migraine [8A80]	[39]
Siponimod	DM2R86O	Moderate	Decreased metabolism of Ivacaftor caused by Siponimod mediated inhibition of CYP450 enzyme.	Multiple sclerosis [8A40]	[10]
Fedratinib	DM4ZBK6	Major	Decreased metabolism of Ivacaftor caused by Fedratinib mediated inhibition of CYP450 enzyme.	Myeloproliferative neoplasm [2A20]	[11]
Netupitant	DMEKAYI	Major	Decreased metabolism of Ivacaftor caused by Netupitant mediated inhibition of CYP450 enzyme.	Nausea/vomiting [MD90]	[11]
Entrectinib	DMMPTLH	Moderate	Decreased metabolism of Ivacaftor caused by Entrectinib mediated inhibition of CYP450 enzyme.	Non-small cell lung cancer [2C25]	[10]
S-297995	DM26IH8	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by S-297995.	Opioid use disorder [6C43]	[11]
Olaparib	DM8QB1D	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Olaparib.	Ovarian cancer [2C73]	[9]
Rucaparib	DM9PVX8	Moderate	Decreased metabolism of Ivacaftor caused by Rucaparib mediated inhibition of CYP450 enzyme.	Ovarian cancer [2C73]	[10]
Abametapir	DM2RX0I	Moderate	Decreased metabolism of Ivacaftor caused by Abametapir mediated inhibition of CYP450 enzyme.	Pediculosis [1G00]	[40]
Lefamulin	DME6G97	Moderate	Decreased metabolism of Ivacaftor caused by Lefamulin mediated inhibition of CYP450 enzyme.	Pneumonia [CA40]	[41]
Enzalutamide	DMGL19D	Major	Increased metabolism of Ivacaftor caused by Enzalutamide mediated induction of CYP450 enzyme.	Prostate cancer [2C82]	[9]
Relugolix	DMK7IWL	Major	Decreased clearance of Ivacaftor due to the transporter inhibition by Relugolix.	Prostate cancer [2C82]	[42]
Riociguat	DMXBLMP	Moderate	Decreased metabolism of Ivacaftor caused by Riociguat mediated inhibition of CYP450 enzyme.	Pulmonary hypertension [BB01]	[9]
Voxelotor	DMCS6M5	Major	Decreased metabolism of Ivacaftor caused by Voxelotor mediated inhibition of CYP450 enzyme.	Sickle-cell disorder [3A51]	[11]
LDE225	DMM9F25	Moderate	Decreased metabolism of Ivacaftor caused by LDE225 mediated inhibition of CYP450 enzyme.	Skin cancer [2C30-2C37]	[43]
Telotristat ethyl	DMDIYFZ	Moderate	Increased metabolism of Ivacaftor caused by Telotristat ethyl mediated induction of CYP450 enzyme.	Small intestine developmental anomaly [DA90]	[11]
Larotrectinib	DM26CQR	Moderate	Decreased metabolism of Ivacaftor caused by Larotrectinib mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[10]
LEE011	DMMX75K	Major	Decreased metabolism of Ivacaftor caused by LEE011 mediated inhibition of CYP450 enzyme.	Solid tumour/cancer [2A00-2F9Z]	[11]
Fostamatinib	DM6AUHV	Moderate	Decreased metabolism of Ivacaftor caused by Fostamatinib mediated inhibition of CYP450 enzyme.	Thrombocytopenia [3B64]	[44]
Lusutrombopag	DMH6IKO	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Lusutrombopag.	Thrombocytopenia [3B64]	[10]
Elagolix	DMB2C0E	Moderate	Increased metabolism of Ivacaftor caused by Elagolix mediated induction of CYP450 enzyme.	Uterine fibroid [2E86]	[10]
Betrixaban	DM2C4RF	Moderate	Decreased clearance of Ivacaftor due to the transporter inhibition by Betrixaban.	Venous thromboembolism [BD72]	[45]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
FD&C blue no. 2	E00446	2723854	Colorant
Sodium lauryl sulfate	E00464	3423265	Emulsifying agent; Modified-release agent; Penetration agent; Solubilizing agent; Surfactant; lubricant
Ammonia	E00007	222	Alkalizing agent
Carmellose sodium	E00625	Not Available	Disintegrant
Ferrosoferric oxide	E00231	14789	Colorant
Lactose monohydrate	E00393	104938	Binding agent; Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate	E00208	11177	lubricant
Polyethylene glycol 3350	E00652	Not Available	Coating agent; Diluent; Ointment base; Plasticizing agent; Solvent; Suppository base; lubricant
Propylene glycol	E00040	1030	Antimicrobial preservative; Humectant; Plasticizing agent; Solvent
Silicon dioxide	E00670	Not Available	Anticaking agent; Opacifying agent; Viscosity-controlling agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Ivacaftor 150 mg tablet	150 mg	Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 4342).
• [2] Oldham HG, Clarke SE: In vitro identification of the human cytochrome P450 enzymes involved in the metabolism of R(+)- and S(-)-carvedilol. Drug Metab Dispos. 1997 Aug;25(8):970-7.
• [3] BDDCS predictions, self-correcting aspects of BDDCS assignments, BDDCS assignment corrections, and classification for more than 175 additional drugs
• [4] FDA Approved Drug Products: Kalydeco (ivacaftor)
• [5] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [6] Investigation of the effects of the CFTR potentiator ivacaftor on human P-glycoprotein (ABCB1). Sci Rep. 2017 Dec 13;7(1):17481.
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• [8] Effect of VX-770 in persons with cystic fibrosis and the G551D-CFTR mutation. N Engl J Med. 2010 Nov 18;363(21):1991-2003. doi: 10.1056/NEJMoa0909825.
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