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People with CF pictured may 
or may not be taking ORKAMBI.

Safety & Side Effects

Learn about ORKAMBI® safety and side effects. 


Serious and
Most Common
Side Effects

Additional Safety Considerations

Liver icon

Worsening of liver function in people with severe liver disease. The worsening of liver function can be serious or cause death. Talk to your doctor if you have been told you have liver disease as your doctor may need to adjust the dose of ORKAMBI.

High liver enzymes in the blood, which can be a sign of liver injury in people receiving ORKAMBI. Your doctor will do blood tests to check your liver:

  • Before you start ORKAMBI
  • Every 3 months during your first year of taking ORKAMBI
  • Every year while you are taking ORKAMBI

You or your child may be able to get these tests done during regular CF Center visits. Talk to your (or your child’s) healthcare provider about how best to schedule these tests.

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Call your doctor right away if you have any of the following symptoms of liver problems:

  • Pain or discomfort in the upper right stomach (abdominal) area
  • Yellowing of your skin or the white part of your eyes
  • Loss of appetite
  • Nausea or vomiting
  • Dark, amber-colored urine
  • Confusion
Breathing issue icon

Breathing problems such as trouble breathing, shortness of breath or chest tightness in patients when starting ORKAMBI, especially in patients who have poor lung function. Call your doctor right away if you experience these symptoms.

Blood pressure monitoring icon

An increase in blood pressure in some people receiving ORKAMBI. Call your doctor right away if you have an increase in blood pressure.

Cataracts icon

Abnormality of the eye lens (cataract) in some children and adolescents receiving ORKAMBI. If you are a child or adolescent, your healthcare provider should perform eye examinations before and during treatment with ORKAMBI to look for cataracts.

The most common side effects of ORKAMBI include:

  • breathing problems such as shortness of breath and chest tightness
  • nausea
  • diarrhea
  • fatigue
  • increase in a certain blood enzyme called creatine phosphokinase
  • rash
  • gas
  • common cold, including sore throat, stuffy or runny nose
  • flu or flu-like symptoms
  • irregular, missed, or abnormal periods (menses) and increase in the amount of menstrual bleeding

Side effects seen in children are similar to those seen in adults and adolescents. Additional common side effects seen in children include:

  • cough with sputum
  • stuffy nose
  • headache
  • stomach pain
  • increase in sputum

These are not all the possible side effects of ORKAMBI. Call your doctor for medical advice about side effects. You are encouraged to report side effects to FDA at 1-800-FDA-1088.

Do not take ORKAMBI if you take certain medicines or herbal supplements, such as:

  • antibiotics: rifampin (RIFAMATE®, RIFATER®) or rifabutin (MYCOBUTIN®)
  • seizure medicines: phenobarbital, carbamazepine (TEGRETOL®, CARBATROL®, and EQUETRO®),
    or phenytoin (DILANTIN®, PHENYTEK®)
  • sedatives and anti-anxiety medicines: triazolam (HALCION®) or midazolam (DORMICUM®,
  • immunosuppressant medicines: cyclosporine, everolimus (ZORTRESS®), sirolimus (RAPAMUNE®),
    or tacrolimus (ASTAGRAF XL®, ENVARSUS XR®, PROGRAF®, and PROTOPIC®)
  • St. John’s wort (Hypericum perforatum)

Talk to your doctor before taking ORKAMBI if you take any of the medicines or supplements listed above.

Before you take ORKAMBI, tell your doctor about all of your medical conditions, including if you:

Liver icon

Have or have had liver problems

Organ transplant icon

Have had an organ transplant

Kidney problem icon

Have kidney problems

Lung problem icon

Have lung problems

Birth control icon

Are using birth control (hormonal contraceptives including oral, injectable, transdermal, or implantable forms). Hormonal contraceptives should not be used as a method of birth control when taking ORKAMBI. Talk to your doctor about the best birth control method you should use while taking ORKAMBI

Pregnant icon

Are pregnant or plan to become pregnant. It is not known if ORKAMBI will harm your unborn baby. You and your doctor should decide if you will take ORKAMBI while you are pregnant

Breastfeeding icon

Are breastfeeding or planning to breastfeed. It is not known if ORKAMBI passes into your breast milk. You and your doctor should decide if you will take ORKAMBI while you are breastfeeding

Taking ORKAMBI with other medicines

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ORKAMBI may affect the way other medicines work, and other medicines may affect how ORKAMBI works.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, because the dose of ORKAMBI may need to be adjusted when taken with certain medicines.


Especially tell your doctor if you take:

Antifungal medications including: Antibiotics including:
Ketoconazole (such as NIZORAL®) Telithromycin (such as KETEK®)
Itraconazole (such as SPORANOX®) Clarithromycin (such as BIAXIN®)
Posaconazole (such as NOXAFIL®) Erythromycin (such as ERY-TAB®)
Voriconazole (such as VFEND®)  
Antifungal medications including:
Ketoconazole (such as NIZORAL®)
Itraconazole (such as SPORANOX®)
Posaconazole (such as NOXAFIL®)
Voriconazole (such as VFEND®)
Antibiotics including:
Telithromycin (such as KETEK®)
Clarithromycin (such as BIAXIN®)
Erythromycin (such as ERY-TAB®)

Remember, it is important to know all the medicines you take. Keep a list to show your doctor and pharmacist whenever you get a new medicine.

Grapefruit icon

Do not eat or drink grapefruit products during your first week of treatment with ORKAMBI. Eating or drinking grapefruit products can increase the amount of ORKAMBI in your blood.