ing these drugs together may increase the plasma concentrations of velpatasvir, potentially resulting in adverse events. Velpatasvir is a substrate of the drug transporter P-glycoprotein (P-gp); ketoconazole is an inhibitor of P-gp. Ketoconazole is also a potent inhibitor of the hepatic enzyme CYP3A4. Velpatasvir is a CYP3A4 substrate.
Lanreotide: Use caution when administering velpatasvir with lanreotide. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Velpatasvir is a substrate of CYP3A4. Lanreotide, a somastatin analog, decreases growth hormone secretion which in turn may inhibit CYP3A4 enzyme function.
Lansoprazole: 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.
Lansoprazole; Naproxen: 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.
Lapatinib: Use caution when administering velpatasvir with lapatinib. Taking these medications together may increase the plasma concentrations of both drugs, potentially resulting in adverse events. Velpatasvir is a substrate of the drug transporter P-glycoprotein (P-gp); lapatinib is an inhibitor of P-gp. Lapatinib is also an inhibitor of the hepatic enzymes CYP3A4 and CYP2C8. Velpatasvir is a substrate of both enzymes. Finally, lapatinib is a substrate for the Breast Cancer Resistance Protein (BCRP); velpatasvir is a BCRP inhibitor.
Ledipasvir; Sofosbuvir: Taking these drugs together is a duplication of therapy, and may result in adverse effects.
Lesinurad: Use caution when administering velpatasvir with lesinurad. Taking these drugs together may decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 substrate; lesinurad is a weak inducer of CYP3A4.
Lopinavir; Ritonavir: Avoid coadministration of velpatasvir with ritonavir. Taking these drugs together may significantly alter the plasma concentrations of velpatasvir, and increase the concentrations of ritonavir. Velpatasvir is a CYP3A4 substrate. Ritonavir is a mixed inducer/inhibitor of CYP3A4. In addition, both ritonavir and velpatasvir are substrates and inhibitors of the drug transporter P-glycoprotein (P-gp). If these drugs are administered together, monitor for loss of antiviral efficacy and adverse effects. Caution is warranted when lopinavir; ritonavir is administered with sofosbuvir as there is a potential for elevated concentrations of sofosbuvir. Lopinavir; ritonvir is an i |
