trate. Caution and close monitoring are advised if these drugs are administered together Concurrent administration of sofosbuvir with dasabuvir; ombitasvir; paritaprevir; ritonavir may result in elevated plasma concentrations of sofosbuvir. Ritonavir is an inhibitor of the breast cancer resistance protein (BCRP); dasabuvir and paritaprevir are substrates/inhibitors of BCRP, while sofosbuvir is a BCRP substrate. Caution and close monitoring are advised if these drugs are administered together.
Dasatinib: Use caution when administering velpatasvir with dasatinib. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Dasatinib is a weak CYP3A4 inhibitor; velpatasvir is a substrate of CYP3A4.
Deferasirox: Avoid coadministration of velpatasvir with deferasirox. Taking these drugs together may significantly alter velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy or adverse effects. Velpatasvir is a substrate of CYP3A4 and CYP2C8; deferasirox is an inducer of CYP3A4 and an inhibitor of CYP2C8.
Delavirdine: Use caution when administering velpatasvir with delavirdine. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Delavirdine is a potent CYP3A4 inhibitor; velpatasvir is a substrate of CYP3A4.
Dexamethasone: Avoid coadministration of velpatasvir with dexamethasone. Taking these drugs together may significantly decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 substrate; dexamethasone a moderate inducer of CYP3A4. Additionally, velpatasvir is an inhibitor of the drug transporter P-glycoprotein (P-gp). Coadministration with substrates of this transporter, such as dexamethasone, may increase their exposure.
Dexlansoprazole: Coadministration of proton pump inhibitors (PPIs) with velpatasvir is not recommended. If it is considered medically necessary to coadminister, velpatasvir should be administered with food and taken 4 hours before omeprazole 20 mg. Other PPIs have not been studied; however, it may be prudent to separate the administration of the other PPIs similarly. Velpatasvir solubility decreases as pH increases; therefore, drugs that increase gastric pH are expected to decrease the concentrations of velpatasvir, potentially resulting in loss of antiviral efficacy.
Dextromethorphan; Quinidine: Use caution when administering velpatasvir with quinidine. Taking these medications together may increase the plasma concentrations of both drugs, potentially resulting in adverse events. Both drugs are substrates and inhibitors of the drug transporter P-glycoprotein (P-gp).
Digoxin: Therapeutic serum concentration monitoring of digoxin is recommended when coadministered with velpatasvir due to the potential for increasedre digoxin serum concentrations. A digoxin dose modification may be necessary. A single-dose pharmacokinetic study showed increases in the Cmax (188%) and AUC (134%) of digoxin when administered with velpatasvir compared to no coadministration. Digoxin is a P-glycoprotein (P-gp) substrate and velpatasvir inhibits P-gp.
Diltiazem: Use caution when administering velpatasvir with diltiazem. Taking these medications together may increase the plasma concentrations of both drugs, potentially resulting in adverse events. Both drugs are subst |
