Basic Information
ID DDInter1388 and DDInter1924
Interaction Coadministration of velpatasvir with proton pump inhibitors may reduce its gastrointestinal absorption. Velpatasvir exhibits pH-dependent solubility, with increased solubility at lower pH.
Management Concomitant use of sofosbuvir-velpatasvir with proton-pump inhibitors should generally be avoided. If coadministration is required, sofosbuvir-velpatasvir should be administered with food and taken 4 hours before the proton-pump inhibitor at a maximum daily dose equivalent to omeprazole 20 mg. Use with other proton-pump inhibitors has not been studied.
References [1] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [2] "Product Information. Epclusa (sofosbuvir-velpatasvir)." Gilead Sciences, Foster City, CA.
Alternative for Pantoprazole A02B
Tinidazole Levofloxacin Tetracycline Sucralfate Misoprostol Bismuth subcitrate potassium
Metronidazole Rifabutin Clarithromycin Vonoprazan Amoxicillin
Alternative for Velpatasvir J05A
Paritaprevir Glecaprevir Tenofovir alafenamide Maraviroc Amprenavir Simeprevir
Zanamivir Cabotegravir Telaprevir Dolutegravir Cobicistat
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.