Symdeko is a combination medication containing tezacaftor and ivacaftor used to treat cystic fibrosis (CF) in people aged 6 years and older. It's for people who have two copies of the F508del mutation (change in DNA) in the CFTR (cystic fibrosis transmembrane conductance regulator) gene or at least one mutation in the CFTR gene that responds to treatment with Symdeko. This medication is typically only available at certain pharmacies.
Cystic fibrosis
Symdeko is a combination of two medications.
Ivacaftor is a CFTR potentiator. It works by keeping chloride "gates" on the CFTR protein open so that salt and water can move freely in the lungs. This helps prevent mucus buildup in the lungs.
Tezacaftor is a CFTR corrector. It works by correcting the shape of the CFTR protein, which is often misshaped in people with CF. Once the CFTR protein forms the correct 3-D shape, it's able to move to the surface of cells in the body and work properly.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Combination medication that works well to target the underlying cause of CF
Packaged as weekly "wallets" that make it clear which tablet you're supposed to take and when you're supposed to take them
Only available as brand medication and is very expensive
Only available at specialty pharmacies
Cannot be used in children younger than 6 years of age
Keep in mind that taking your Symdeko doses about 12 hours apart is not the same as taking it twice a day. Set alarms, sticky notes, or other reminders for yourself to help remember to take it on time every 12 hours.
Always take Symdeko with foods high in fat to help your body absorb the medication better.
Avoid foods or drinks with grapefruit, because these might raise the amount of Symdeko in your body.
Talk to your provider before starting, changing, or stopping any medications while taking Symdeko, including prescription and non-prescription medications, vitamins, and supplements. Symdeko can interact with certain medications, so it's important that your provider knows about all the medications you take or plan to take to make sure they're safe for you.
You can follow these tips and tricks to help encourage your child to take this medication safely and on time every day.
Symdeko can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of liver problems
Symdeko can sometimes cause abnormally high liver test results. Your provider will check your liver before you start Symdeko, then every 3 months for the next year, and then every year after that. If you have a history of liver problems, your provider might check your liver labs more often. While taking this medication, if you experience stomach pain, dark-colored urine, pale-colored stools, or yellowing of the skin or eyes, get medical help right away.
Taking Symdeko along with certain medications can affect the amount of Symdeko in your body, how well it works, and the risk of side effects.
Some medications, like the antibiotic, rifampin, and a common supplement, St. John's wort, can lower the amount of Symdeko in your body. This can make Symdeko not work as well.
Other medications can raise the levels of Symdeko in your body. You'll also want to avoid grapefruit and grapefruit juice while taking this medication, because grapefruit might cause you to have too much medication in your body as well. This can lead to a higher risk of side effects.
Symdeko can also affect how other medications work, so tell your provider and pharmacist about all the medications and supplements you're taking before starting Symdeko. They will make sure all your medications are safe for you to take.
Risk factors: Taking steroid medications | Exposure to radiation
Symdeko can cause cataracts in children. Your child's provider will likely give your child an eye exam before starting the medication and throughout treatment.
The typical dose is 1 tezacaftor/ivacaftor combination tablet by mouth in the morning with a high-fat meal and 1 ivacaftor tablet in the evening with a high-fat meal or snack. Take the morning and evening dose about 12 hours apart.
Symdeko is packaged with two different tablets: a fixed-dose tezacaftor/ivacaftor combination tablet and an ivacaftor-only tablet.
Adults and children 6 years or older weighing at least 66 lbs (30 kg): The combination tablets contain 100 mg/150 mg (tezacaftor/ivacaftor) and the ivacaftor-only tablets contain 150 mg of ivacaftor.
Children 6 to 12 years old weighing less than 66 lbs (30 kg): The combination tablets contain 50 mg/75 mg (tezacaftor/ivacaftor) and the ivacaftor-only tablets contain 75 mg of ivacaftor.
The dose might differ if you or your child has liver problems or if you're taking certain medications.
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