Ledipasvir and sofosbuvir interactions

Ledipasvir and sofosbuvir (Harvoni), an antiviral has 206 documented interactions across the FDA labels and fact sheets we index: 48 major, 124 moderate, 10 minor, and 24 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (48)

  • AbacavirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Abacavir and lamivudineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • AmiodaroneantiarrhythmicMajor

    Coadministration of amiodarone with ledipasvir and sofosbuvir is not recommended. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Amlodipine and atorvastatindihydropyridine calcium channel blockerMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • AtazanavirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • AtorvastatinstatinMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • CabotegravirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • 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) ] . (Colchicine label, Drug interactions)

  • DabigatrananticoagulantMajor

    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) ] . (Dabigatran label, Warnings and precautions)

  • DarunavirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Darunavir and cobicistatantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Digoxindigitalis glycosideMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • DolutegravirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • DoravirineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EfavirenzantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EmtricitabineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Emtricitabine and tenofovirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EtravirineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EverolimusimmunosuppressantMajor

    Strong CYP3A inhibitor and P-gp inhibitor : Avoid coadministration. (Everolimus label, Drug interactions)

  • FosamprenavirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LamivudineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Lamivudine and zidovudineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LenacapavirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Lopinavir and ritonavirantiretroviralMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LorlatinibCYP3A4 inducerMajor

    Use of ledipasvir and sofosbuvir with P-gp inducers is not recommended. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MaravirocantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • NevirapineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • 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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Avoid concomitant use of VOTRIENT with strong inhibitors of P-gp or BCRP. (Pazopanib label, Drug interactions)

  • RaltegravirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RibavirinantiviralMajor

    If ledipasvir and sofosbuvir is administered with ribavirin, the contraindications to ribavirin also apply to this combination regimen. (Ledipasvir and sofosbuvir label, Contraindications)

  • RifabutinantibioticMajor

    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) ]. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RifampinantibioticMajor

    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) ]. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RifapentineantibioticMajor

    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) ]. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RilpivirineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

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

  • RitonavirantiretroviralMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RosuvastatinstatinMajor

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • SirolimusimmunosuppressantMajor

    • 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 ). (Sirolimus label, Drug interactions)

  • 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. (Talazoparib label, Drug interactions)

  • TenofovirantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Avoid concomitant use HYCAMTIN capsules with P-gp inhibitors or BCRP inhibitors. (Topotecan label, Drug interactions)

  • Therefore, the concomitant use of P-gp inhibitors or inducers should be avoided. (Vincristine label, Drug interactions)

  • ZidovudineantiretroviralMajor

    Consider alternative HCV or antiretroviral therapy to avoid increases in tenofovir exposures. (Ledipasvir and sofosbuvir label, Drug interactions)

Moderate interactions (124)

  • AbataceptimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • AbrocitinibJAK inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Acebutololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • AdalimumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • AdenosineantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • AfatinibModerate

    P-glycoprotein (P-gp) Inhibitors : Co-administration of P-gp inhibitors can increase afatinib exposure. (Afatinib label, Drug interactions)

  • AlemtuzumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Antacids (e.g., aluminum and magnesium hydroxide) It is recommended to separate antacid and ledipasvir and sofosbuvir administration by 4 hours. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Atenololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Atenolol and chlorthalidonebeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • AzathioprineimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • BaricitinibJAK inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Betaxololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Bisoprololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • 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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Brimonidine and timololalpha-adrenergic agonistModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • BrivaracetamanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Cannabidiol (prescription)anticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • CarbamazepineanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Carvedilolbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • CenobamateanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • CimetidineH2 blockerModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • CladribineantimetaboliteModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • ClobazambenzodiazepineModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • ClonazepambenzodiazepineModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • CyclophosphamideimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • CyclosporineimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Dexlansoprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Diltiazemcalcium channel blockerModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Dimethyl fumarateimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • DisopyramideantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Divalproex (valproate)anticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • DofetilideantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Dorzolamide and timololcarbonic anhydrase inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • DronedaroneantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EdoxabananticoagulantModerate

    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. (Edoxaban label, Drug interactions)

  • EslicarbazepineanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Esmololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Esomeprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EtanerceptimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • EthosuximideanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • 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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • FamotidineH2 blockerModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • FelbamateanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Fidaxomicinmacrolide antibioticModerate

    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. (Fidaxomicin label, Drug interactions)

  • FingolimodimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • FlecainideantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • FluvastatinstatinModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • FosphenytoinanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • GabapentinanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • GuselkumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • 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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • IbutilideantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • InfliximabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Labetalolbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • LacosamideanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LamotrigineanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Lansoprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LeflunomideimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • LevetiracetamanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Lidocainelocal anestheticModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Lidocaine and prilocainelocal anestheticModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LoperamideQT-prolonging drugModerate

    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. (Loperamide label, Drug interactions)

  • LovastatinstatinModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MagnesiumVitamin and mineralModerate

    Antacids (e.g., aluminum and magnesium hydroxide) It is recommended to separate antacid and ledipasvir and sofosbuvir administration by 4 hours. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MercaptopurineantimetaboliteModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • MethotrexateimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • MethsuximideanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Metoprololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • 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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • MexiletineantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MorphineopioidModerate

    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. (Morphine label, Drug interactions)

  • MycophenolateimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Nadololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Naldemedineopioid antagonistModerate

    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) ] . (Naldemedine label, Drug interactions)

  • 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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • NatalizumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Nebivololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • NizatidineH2 blockerModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • OcrelizumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Omeprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Omeprazole and sodium bicarbonateproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • OxcarbazepineanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Pantoprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PerampanelanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PhenobarbitalbarbiturateModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • 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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Phentermine and topiramateCNS stimulantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PhenytoinanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Pimecrolimuscalcineurin inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Pindololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • PitavastatinstatinModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PonesimodimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • PravastatinstatinModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PregabalinanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PrimidoneanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • ProcainamideantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • PropafenoneantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Propranololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • QuinidineantiarrhythmicModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Rabeprazoleproton pump inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RanitidineH2 blockerModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • RifaximinantibioticModerate

    • 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. (Rifaximin label, Warnings and precautions)

  • RitlecitinibJAK inhibitorModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • RituximabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • RufinamideanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • SecukinumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • SimvastatinstatinModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Sodium bicarbonateantacidModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Sotalolbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TacrolimusimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TeriflunomideimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TiagabineanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Timololbeta blockerModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TocilizumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TofacitinibimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • TopiramateanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • UpadacitinibimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • UstekinumabimmunosuppressantModerate

    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. (Ledipasvir and sofosbuvir label, Warnings and precautions)

  • Valproic acidanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Verapamilcalcium channel blockerModerate

    Antiarrhythmics: amiodarone Effect on amiodarone, ledipasvir, and sofosbuvir concentrations unknown Coadministration of amiodarone with ledipasvir and sofosbuvir may result in serious symptomatic bradycardia. (Ledipasvir and sofosbuvir label, Drug interactions)

  • VigabatrinanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • WarfarinanticoagulantModerate

    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… (Ledipasvir and sofosbuvir label, Drug interactions)

  • ZonisamideanticonvulsantModerate

    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. (Ledipasvir and sofosbuvir label, Drug interactions)

Minor mentions (10)

  • DapagliflozinSGLT2 inhibitorMinor

    Dapagliflozin or dapagliflozin 3-O-glucuronide did not meaningfully inhibit P-gp, OCT2, OAT1, or OAT3 active transporters. (Dapagliflozin label, Drug interactions)

  • Dextromethorphan and quinidineserotonergic drugMinor

    Digoxin Quinidine is an inhibitor of P-glycoprotein. (Dextromethorphan and quinidine label, Drug interactions)

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

  • P-glycoprotein Substrates Lomitapide is an inhibitor of P-glycoprotein (P-gp). (Lomitapide label, Drug interactions)

  • MefloquineantimalarialMinor

    Substrates and Inhibitors of P-glycoprotein It has been shown in vitro that mefloquine is a substrate and an inhibitor of P-glycoprotein. (Mefloquine label, Drug interactions)

  • QuinineantimalarialMinor

    Quinine inhibits P-gp and has the potential to affect the transport of drugs that are P-gp substrates. (Quinine label, Drug interactions)

  • Silodosinalpha blockerMinor

    Strong P-glycoprotein (P-gp) Inhibitors In vitro studies indicated that silodosin is a P‑gp substrate. (Silodosin label, Drug interactions)

  • 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. (Sofosbuvir and velpatasvir label, Drug interactions)

  • St. John's wortHerbal and supplementMinor

    John's wort (Hypericum perforatum) ↓ ledipasvir ↓ sofosbuvir Coadministration of ledipasvir and sofosbuvir with St. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Mechanism and Clinical Effect(s) Vepdegestrant is a P-gp inhibitor. (Vepdegestrant label, Drug interactions)

No significant interaction reported (24)

  • Conjugated estrogensestrogenNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Desogestrel and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Drospirenone and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • EstradiolestrogenNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Estradiol and dienogestoral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Estradiol and norethindroneestrogenNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Ethynodiol diacetate and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • FulvestrantestrogenNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • LevonorgestrelprogestinNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Levonorgestrel and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MedroxyprogesteroneprogestinNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MegestrolprogestinNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MethadoneopioidNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MidazolambenzodiazepineNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • MifepristoneCYP3A4 inhibitorNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • NorethindroneprogestinNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Norethindrone and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Norgestimate and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • Norgestrel and ethinyl estradioloral contraceptiveNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

  • ProgesteroneprogestinNo interaction

    …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. (Ledipasvir and sofosbuvir label, Drug interactions)

Check Ledipasvir and sofosbuvir against everything you take. Add your full list; every pair is checked at once.

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.