Drug interactions
Amiodarone + Sofosbuvir-velpatasvir
Severity: Major
Amiodarone and Sofosbuvir-velpatasvir: 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
Co-administration of sofosbuvir-containing regimens with amiodarone has been associated with severe symptomatic bradycardia, including fatal cases and pacemaker insertion. Risk appears higher with beta-blockers, cardiac disease or advanced liver disease.
What this interaction means in plain words
Amiodarone and Sofosbuvir-velpatasvir 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.
Amiodarone belongs to Cardiovascular; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
The mechanism is not established; an additive effect on cardiac conduction is suspected.
What to do
Avoid the combination where possible; if unavoidable, monitor the patient with continuous cardiac monitoring in hospital for the first 48 hours, then check heart rate daily or self-monitor for the first 2 weeks.
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 Sofosbuvir-velpatasvir
- Rifampin + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Sofosbuvir-velpatasvir + St john's wort Contraindicated
- Apalutamide + Sofosbuvir-velpatasvir Major
- Carbamazepine + Sofosbuvir-velpatasvir Major
- Dabrafenib + Sofosbuvir-velpatasvir Major
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 Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Amiodarone and Sofosbuvir-velpatasvir 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. Co-administration of sofosbuvir-containing regimens with amiodarone has been associated with severe symptomatic bradycardia, including fatal cases and pacemaker insertion. Risk appears higher with beta-blockers, cardiac disease or advanced liver disease.
How serious is the interaction between Amiodarone and Sofosbuvir-velpatasvir?
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 the combination where possible; if unavoidable, monitor the patient with continuous cardiac monitoring in hospital for the first 48 hours, then check heart rate daily or self-monitor for the first 2 weeks.
What other medicines interact with Sofosbuvir-velpatasvir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir with, for example, Rifampin, Rifapentine, St john's wort. The full list is on the Sofosbuvir-velpatasvir page.
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