patasvir, potentially resulting in loss of antiviral efficacy.
Oritavancin: Use caution when administering velpatasvir with oritavancin. Taking these drugs together may decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 substrate; oritavancin is a weak inducer of CYP3A4.
Osimertinib: Use caution if coadministration of osimertinib with sofosbuvir is necessary, due to the risk of increased sofosbuvir exposure. Osimertinib is an in vitro BCRP inhibitor; sofosbuvir is a BCRP substrate. Coadministration of osimertinib with rosuvastatin, a BCRP substrate, increased the rosuvastatin AUC and Cmax by 35% and 72%, respectively; exposure to sofosbuvir may also be expected to increase. Coadministration may increase sofosbuvir-related adverse reactions. Use caution if coadministration of velpatasvir with osimertinib is necessary, due to the risk of increased exposure to osimertinib and velpatasvir; monitor for osimertinib- and velpatasvir-related adverse reactions. Osimertinib is an inhibitor of the breast cancer resistance protein (BCRP) drug transporter in vitro; velpatasvir is a BCRP substrate. Coadministration of osimertinib with rosuvastatin, a BCRP substrate, increased the rosuvastatin AUC and Cmax by 35% and 72%, respectively. In addition, velpatasvir is an inhibitor of the drug transporters BCRP and P-glycoprotein (P-gp). Coadministration with substrates of these transporters, such as osimertinib (in vitro), may increase their exposure.
Ospemifene: Use caution when administering velpatasvir with ospemifene. Taking these drugs together may increase the plasma concentrations of velpatasvir, potentially resulting in adverse events. Ospemifene is a weak in vitro inhibitor of the hepatic enzymes CYP3A4, CYP2C8, and CYP2B6. Velpatasvir is a substrate of all three enzymes.
Oxcarbazepine: Avoid coadministration of sofosbuvir with oxcarbazepine. Taking these drugs together may decrease sofosbuvir plasma concentration, potentially resulting in loss of antiviral efficacy. Avoid coadministration of velpatasvir with inducers of CYP3A4, such as oxcarbazepine. Taking these drugs together may significantly decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 substrate.
Palbociclib: Use caution when administering velpatasvir with palbociclib. Taking these drugs together may increase velpatasvir plasma concentrations, potentially resulting in adverse events. Palbociclib is a weak CYP3A4 inhibitor; velpatasvir is a substrate of CYP3A4.
Paliperidone: Use caution when administering velpatasvir with paliperidone. 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); paliperidone is a weak inhibitor of P-gp.
Pantoprazole: 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 res |
