gs, potentially resulting in adverse events. Both drugs are substrates and inhibitors of the drug transporter P-glycoprotein (P-gp). In addition, nelfinavir is a potent inhibitor of the hepatic enzyme CYP3A4. Velpatasvir is a CYP3A4 substrate.
Netupitant; Palonosetron: Use caution when administering velpatasvir with netupitant. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Netupitant is a CYP3A4 inhibitor; velpatasvir is a substrate of CYP3A4.
Nevirapine: Avoid coadministration of velpatasvir with inducers of CYP3A4 and CYP2B6, such as nevirapine. Taking these drugs together may significantly decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 and CYP2B6 substrate.
Niacin; Simvastatin: Use caution when administering velpatasvir with simvastatin. 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). Additionally, velpatasvir is an inhibitor of the organic anion transporting polypeptides OATP1B1 and OATP1B3. Simvastation is an OATP substrate.
Nicardipine: Use caution when administering velpatasvir with nicardipine. Taking 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); nicardipine is a potent inhibitor of P-gp. Nicardipine is also an in vitro inhibitor of the hepatic enzymes CYP3A4 and CYP2C8. Velpatasvir is a substrate of both enzymes.
Nifedipine: Use caution when administering velpatasvir with nifedipine. Taking 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); nifedipine is a weak inhibitor of P-gp.
Nilotinib: Avoid coadministration of velpatasvir with nilotinib. Taking these drugs together may significantly alter the plasma concentrations of velpatasvir, potentially resulting in loss of antiviral efficacy or adverse effects. Velpatasvir is a substrate of the drug transporter P-glycoprotein (P-gp); nilotinib is a P-gp inhibitor. Velpatasvir is also a substrate for CYP2B6, CYP3A4, and CYP2C8; nilotinib is an inducer of CYP2B6, an inhibitor of CYP3A4, and an inhibitor/inducer of CYP2C8.
Nizatidine: H2-blockers may be administered simultaneously with or 12 hours apart from velpatasvir. H2-blocker doses should not exceed doses comparable to famotidine 40 mg twice daily. 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.
Octreotide: Use caution when administering velpatasvir with octreotide. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Velpatasvir is a substrate of CYP3A4. Octreotide, a somastatin analog, decreases growth hormone secretion which in turn may inhibit CYP3A4 enzyme function.
Olaparib: Use caution if coadministration of olaparib with sofosbuvir is necessary, due to an increased risk of sofosbuvir-related adverse reactions. Sofosbuvir is a substrate of P-glycoprotein (P-gp) |
