a P-glycoprotein (P-gp) substrate / inhibitor in vitro. Velpatasvir is also a P-gp substrate / inhibitor. Pharmacokinetic data are not available for concomitant use of temsirolimus with P-gp inhibitors or substrates, but exposure to both velpatasvir and temsirolimus (and active metabolite, sirolimus) is likely to increase. Use caution if coadministration of temsirolimus with sofosbuvir is necessary, and monitor for an increase in sofosbuvir-related adverse reactions. Temsirolimus is a P-glycoprotein (P-gp) inhibitor in vitro, and sofosbuvir is a P-gp substrate. However, the FDA-labeling suggests that inhibitors of P-gp may be coadministered with sofosbuvir. In clinical trials, no clinically significant interaction was noted when sofosbuvir was administered with darunavir/ritonavir (both P-gp inhibitors) or cyclosporine (a P-gp and BCRP inhibitor). Pharmacokinetic data are not available for concomitant use of temsirolimus with P-gp substrates.
Tenofovir Alafenamide: Monitor patients for tenofovir-associated adverse reactions, such as renal toxicity, in patients receiving regimens containing tenofovir alafenamide and velpatasvir due to potential increases in tenofovir serum concentrations. Tenofovir alafenamide is a substrate of the breast cancer resistance protein (BCRP),P-glycoprotein (P-gP), OATP1B1, and OATB1B3 transporters, while velpatasvir inhibits these transporters.
Tenofovir Alafenamide: Monitor patients for tenofovir-associated adverse reactions, such as renal toxicity, in patients receiving regimens containing tenofovir alafenamide and velpatasvir due to potential increases in tenofovir serum concentrations. Tenofovir alafenamide is a substrate of the breast cancer resistance protein (BCRP),P-glycoprotein (P-gP), OATP1B1, and OATB1B3 transporters, while velpatasvir inhibits these transporters.
Tenofovir, PMPA: Monitor patients for tenofovir-associated adverse reactions, such as renal toxicity, in patients receiving regimens containing tenofovir and velpatasvir due to potential increases in tenofovir serum concentrations. Tenofovir is a substrate of the breast cancer resistance protein (BCRP) and P-glycoprotein (P-gp) transporters, while velpatasvir inhibits both BCRP and P-gp.
Teriflunomide: Use caution when administering velpatasvir with teriflunomide. Taking these drugs together may increase the plasma concentrations of velpatasvir, potentially resulting in adverse events. Velpatasvir is a substrate of the Breast Cancer Resistance Protein (BCRP); teriflunomide is an inhibitor of BCRP. Teriflunomide is also an inhibitor of the hepatic enzyme CYP2C8. Velpatasvir is a CYP2C8 substrate.
Testosterone: Use caution when administering velpatasvir with testosterone. 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).
Ticagrelor: Use caution when administering velpatasvir with ticagrelor. 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). In addition, ticagrelor is a weak inhibitor of the hepatic enzyme CYP3A4. Velpatasvir is a CYP3A4 substrate.
Ticlopidine: Use caution when administering velpatasvir with ticlopidine. Taking these drugs |
