Drug interactions
Amiodarone + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Major
Amiodarone and Sofosbuvir-velpatasvir-voxilaprevir: 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
Sofosbuvir-containing regimens given with amiodarone have been linked to serious symptomatic bradycardia, including cardiac arrest, death and pacemaker placement. Risk is higher with beta blockers, underlying heart disease or advanced liver disease. Onset can occur within hours to days of starting.
What this interaction means in plain words
Amiodarone and Sofosbuvir-velpatasvir-voxilaprevir 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-voxilaprevir belongs to Anti Virals.
Why it happens
The mechanism is not established; an additive or synergistic effect on cardiac conduction is suspected.
What to do
Avoid coadministration where possible and use an alternative antiarrhythmic or HCV regimen. If it is unavoidable, monitor the heart rate with inpatient cardiac monitoring for the first 48 hours and then daily self-checks or outpatient monitoring for at least 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-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
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-voxilaprevir?
MediHelp rates the interaction as major. Amiodarone and Sofosbuvir-velpatasvir-voxilaprevir 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. Sofosbuvir-containing regimens given with amiodarone have been linked to serious symptomatic bradycardia, including cardiac arrest, death and pacemaker placement. Risk is higher with beta blockers, underlying heart disease or advanced liver disease. Onset can occur within hours to days of starting.
How serious is the interaction between Amiodarone and Sofosbuvir-velpatasvir-voxilaprevir?
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 where possible and use an alternative antiarrhythmic or HCV regimen. If it is unavoidable, monitor the heart rate with inpatient cardiac monitoring for the first 48 hours and then daily self-checks or outpatient monitoring for at least 2 weeks.
What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.
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