ing velpatasvir with boceprevir. 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, boceprevir is a potent inhibitor of the hepatic enzyme CYP3A4. Velpatasvir is a CYP3A4 substrate.
Bosentan: Avoid coadministration of velpatasvir with bosentan. Taking these drugs together may significantly decrease velpatasvir plasma concentrations, potentially resulting in loss of antiviral efficacy. Velpatasvir is a CYP3A4 substrate; bosentan is an inducer of CYP3A4. Additionally, velpatasvir is an inhibitor of the organic anion transporting polypeptides OATP1B1 and OATP1B3. Coadministration with substrates of these transporters, such as bosentan, may increase their exposure.
Cabozantinib: Monitor for an increase in ledipasvir; sofosbuvir-related adverse events if concomitant use with cabozantinib is necessary, as plasma concentrations of ledipasvir and sofosbuvir may be increased. Cabozantinib is a P-glycoprotein (P-gp) inhibitor and both ledipasvir and sofosbuvir are substrates of P-gp; the clinical relevance of this finding is unknown. Use caution when administering velpatasvir with cabozantinib. 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); cabozantinib is an inhibitor of P-gp.
Calcium Carbonate: Separate the use of antacids (e.g., calcium carbonate) and sofosbuvir; velpatasvir administration by 4 hours. 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.
Calcium Carbonate; Magnesium Hydroxide: Separate the use of antacids (e.g., calcium carbonate) and sofosbuvir; velpatasvir administration by 4 hours. 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. Separate the use of antacids and velpatasvir administration by 4 hours. 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.
Calcium Carbonate; Risedronate: Separate the use of antacids (e.g., calcium carbonate) and sofosbuvir; velpatasvir administration by 4 hours. 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.
Calcium; Vitamin D: Separate the use of antacids (e.g., calcium carbonate) and sofosbuvir; velpatasvir administration by 4 hours. 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.
Canagliflozin: Use caution when administering velpatasvir with canagliflozin. 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-g |
