Wechselwirkungen von Ledipasvir und Sofosbuvir

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration of amiodarone with ledipasvir and sofosbuvir is not recommended. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Coadministration of ledipasvir and sofosbuvir with rosuvastatin is not recommended. atorvastatin ↑ atorvastatin Coadministration of ledipasvir and sofosbuvir with atorvastatin may be associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration of ledipasvir and sofosbuvir with rosuvastatin is not recommended. atorvastatin ↑ atorvastatin Coadministration of ledipasvir and sofosbuvir with atorvastatin may be associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

P-glycoprotein The concomitant use of colchicine capsules and inhibitors of P-glycoprotein (e.g. clarithromycin, ketoconazole, cyclosporine, etc.) should be avoided due to the potential for serious and life-threatening toxicity [see Warnings and Precautions (5.3) and Clinical Pharmacology (12) ] . (Fachinformation zu Colchicin, Arzneimittelwechselwirkungen)

Avoid use of PRADAXA Capsules and P-gp inhibitors in patients with severe renal impairment (CrCl 15-30 mL/min) [see Drug Interactions (7.1) and Use in Specific Populations (8.6) ] . (Fachinformation zu Dabigatran, Warnhinweise und Vorsichtsmaßnahmen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration of amiodarone with ledipasvir and sofosbuvir is not recommended; if coadministration is required, cardiac monitoring is recommended [see Warnings and Precautions (5.2) , Adverse Reactions (6.2) ]. digoxin ↑ digoxin Coadministration of ledipasvir and sofosbuvir with digoxin may increase the concentration of digoxin. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Strong CYP3A inhibitor and P-gp inhibitor : Avoid coadministration. (Fachinformation zu Everolimus, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration is not recommended. tipranavir/ritonavir ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with tipranavir/ritonavir is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Use of ledipasvir and sofosbuvir with P-gp inducers is not recommended. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration is not recommended. tipranavir/ritonavir ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with tipranavir/ritonavir is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Avoid concomitant use of VOTRIENT with strong inhibitors of P-gp or BCRP. (Fachinformation zu Pazopanib, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

If ledipasvir and sofosbuvir is administered with ribavirin, the contraindications to ribavirin also apply to this combination regimen. (Fachinformation zu Ledipasvir und Sofosbuvir, Gegenanzeigen)

Antimycobacterials: rifabutin rifampin rifapentine ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with rifampin, rifabutin, or rifapentine is not recommended [see Warnings and Precautions (5.3) ]. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antimycobacterials: rifabutin rifampin rifapentine ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with rifampin, rifabutin, or rifapentine is not recommended [see Warnings and Precautions (5.3) ]. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antimycobacterials: rifabutin rifampin rifapentine ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with rifampin, rifabutin, or rifapentine is not recommended [see Warnings and Precautions (5.3) ]. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

• Potent Inhibitors of P-gp: Avoid another dose of NURTEC ODT within 48 hours when administered with a potent P-gp inhibitor. (Fachinformation zu Rimegepant, Arzneimittelwechselwirkungen)

Coadministration is not recommended. tipranavir/ritonavir ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with tipranavir/ritonavir is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Coadministration of ledipasvir and sofosbuvir with rosuvastatin is not recommended. atorvastatin ↑ atorvastatin Coadministration of ledipasvir and sofosbuvir with atorvastatin may be associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

• Avoid concomitant use with strong CYP3A4/P-gp inducers or strong CYP3A4/P-gp inhibitors that decrease or increase sirolimus concentrations ( 7.4 , 12.3 ). (Fachinformation zu Sirolimus, Arzneimittelwechselwirkungen)

Effect of Other Drugs on TALZENNA Effect of P-gp Inhibitors Breast Cancer Avoid coadministration of TALZENNA with the following P-gp inhibitors: itraconazole, amiodarone, carvedilol, clarithromycin, itraconazole, and verapamil. (Fachinformation zu Talazoparib, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Avoid concomitant use HYCAMTIN capsules with P-gp inhibitors or BCRP inhibitors. (Fachinformation zu Topotecan, Arzneimittelwechselwirkungen)

Therefore, the concomitant use of P-gp inhibitors or inducers should be avoided. (Fachinformation zu Vincristin, Arzneimittelwechselwirkungen)

Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

P-glycoprotein (P-gp) Inhibitors : Co-administration of P-gp inhibitors can increase afatinib exposure. (Fachinformation zu Afatinib, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antacids (e.g., aluminum and magnesium hydroxide) It is recommended to separate antacid and ledipasvir and sofosbuvir administration by 4 hours. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

P-gp Inhibitors Treatment of NVAF Based on clinical experience from the ENGAGE AF-TIMI 48 study, dose reduction in patients concomitantly receiving P-gp inhibitors resulted in edoxaban blood levels that were lower than in patients who were given the full dose. (Fachinformation zu Edoxaban, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concentrations of fidaxomicin and OP-1118 may also be decreased at the site of action (i.e., gastrointestinal tract) via P-gp inhibition; however, concomitant P-gp inhibitor use had no attributable effect on safety or treatment outcome of fidaxomicin-treated adult patients in controlled clinical trials. (Fachinformation zu Fidaxomicin, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Drug Interactions Effects of Other Drugs on Loperamide Concomitant use of loperamide hydrochloride capsules with inhibitors of CYP3A4 (e.g., itraconazole) or CYP2C8 (e.g., gemfibrozil) or inhibitors of P-glycoprotein (e.g., quinidine, ritonavir) can increase exposure to loperamide. (Fachinformation zu Loperamid, Arzneimittelwechselwirkungen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antacids (e.g., aluminum and magnesium hydroxide) It is recommended to separate antacid and ledipasvir and sofosbuvir administration by 4 hours. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

P-Glycoprotein (P-gp) Inhibitors Clinical Impact: The concomitant use of P-gp inhibitors can increase the exposure to morphine by two-fold and can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. (Fachinformation zu Morphin, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

P-glycoprotein (P-gp) Inhibitors (e.g., amiodarone, captopril, cyclosporine, quercetin, quinidine, verapamil) Clinical Impact Increase in plasma naldemedine concentrations [see Clinical Pharmacology (12.3) ] Intervention Monitor for potential naldemedine-related adverse reactions [see Adverse Reactions (6.1) ] . (Fachinformation zu Naldemedin, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

• Concomitant P-glycoprotein (P-gp) inhibitors (e.g., cyclosporine): Caution should be exercised when concomitant use of XIFAXAN and a P-glycoprotein inhibitor is needed. (Fachinformation zu Rifaximin, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HMG-CoA Reductase Inhibitors: rosuvastatin ↑ rosuvastatin Coadministration of ledipasvir and sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease, may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Frequent monitoring of relevant laboratory parameters (e.g., International Normalized Ratio [INR] in patients taking warfarin, blood glucose levels in diabetic patients) or drug concentrations of concomitant medications such as cytochrome P450 substrates with a narrow therapeutic index (e.g., certain immunosuppressants) is recommended to ensure safe and effective… (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Anticonvulsants: carbamazepine phenytoin phenobarbital ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with carbamazepine, phenytoin, or phenobarbital is expected to decrease the concentration of ledipasvir and sofosbuvir, leading to reduced therapeutic effect of ledipasvir and sofosbuvir. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

Quinine inhibits P-gp and has the potential to affect the transport of drugs that are P-gp substrates. (Fachinformation zu Chinin, Arzneimittelwechselwirkungen)

Dapagliflozin or dapagliflozin 3-O-glucuronide did not meaningfully inhibit P-gp, OCT2, OAT1, or OAT3 active transporters. (Fachinformation zu Dapagliflozin, Arzneimittelwechselwirkungen)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (Fachinformation zu Dextromethorphan und Chinidin, Arzneimittelwechselwirkungen)

Effects of Other Drugs on HALAVEN No drug-drug interactions are expected with CYP3A4 inhibitors, CYP3A4 inducers or P-glycoprotein (P-gp) inhibitors. (Fachinformation zu Eribulin, Arzneimittelwechselwirkungen)

John's wort (Hypericum perforatum) ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with St. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

P-glycoprotein Substrates Lomitapide is an inhibitor of P-glycoprotein (P-gp). (Fachinformation zu Lomitapid, Arzneimittelwechselwirkungen)

Substrates and Inhibitors of P-glycoprotein It has been shown in vitro that mefloquine is a substrate and an inhibitor of P-glycoprotein. (Fachinformation zu Mefloquin, Arzneimittelwechselwirkungen)

Strong P-glycoprotein (P-gp) Inhibitors In vitro studies indicated that silodosin is a P‑gp substrate. (Fachinformation zu Silodosin, Arzneimittelwechselwirkungen)

Potential for Other Drugs to Affect VOSEVI Sofosbuvir, velpatasvir, and voxilaprevir are substrates of drug transporters P-gp and BCRP while GS-331007 (predominant circulating metabolite of sofosbuvir) is not. (Fachinformation zu Sofosbuvir und Velpatasvir, Arzneimittelwechselwirkungen)

Mechanism and Clinical Effect(s) Vepdegestrant is a P-gp inhibitor. (Fachinformation zu Vepdegestrant, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

…sofosbuvir is used with the following drugs [see Clinical Pharmacology (12.3) ]: abacavir, atazanavir/ritonavir, cyclosporine, darunavir/ritonavir, dolutegravir, efavirenz, elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide, emtricitabine, lamivudine, methadone, midazolam, oral contraceptives, pravastatin, raltegravir, rilpivirine, tacrolimus, or verapamil. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)