Drug interactions
Amiodarone + Ledipasvir / sofosbuvir
Severity: Major
Amiodarone and Ledipasvir / sofosbuvir: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Postmarketing reports describe severe symptomatic bradycardia, including fatal cases and pacemaker implantation, when amiodarone was combined with sofosbuvir-containing regimens. Risk appears higher with beta blockers, cardiac disease or advanced liver disease.
What this interaction means in plain words
Amiodarone and Ledipasvir / sofosbuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Mechanism is not established; additive bradycardic effects are suspected.
What to do
Avoid coadministration when possible; if unavoidable, monitor the patient in hospital with cardiac monitoring for the first 48 hours, then check heart rate daily or self-monitor for weeks. Counsel patients to report dizziness, syncope or slow pulse promptly.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Ledipasvir / sofosbuvir?
MediHelp rates the interaction as major. Amiodarone and Ledipasvir / sofosbuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Postmarketing reports describe severe symptomatic bradycardia, including fatal cases and pacemaker implantation, when amiodarone was combined with sofosbuvir-containing regimens. Risk appears higher with beta blockers, cardiac disease or advanced liver disease.
How serious is the interaction between Amiodarone and Ledipasvir / sofosbuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid coadministration when possible; if unavoidable, monitor the patient in hospital with cardiac monitoring for the first 48 hours, then check heart rate daily or self-monitor for weeks. Counsel patients to report dizziness, syncope or slow pulse promptly.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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