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
Postmarketing reports describe severe symptomatic bradycardia, including fatal cardiac arrest and pacemaker placement, when amiodarone was combined with sofosbuvir-containing regimens. Risk appears greater with beta blockers, cardiac disease or advanced liver disease, and onset can occur within hours to days.
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.
Why it happens
The mechanism is not established; a pharmacodynamic 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 patient with continuous cardiac monitoring in an inpatient setting for the first 48 hours, then daily heart rate checks for at least 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 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. Postmarketing reports describe severe symptomatic bradycardia, including fatal cardiac arrest and pacemaker placement, when amiodarone was combined with sofosbuvir-containing regimens. Risk appears greater with beta blockers, cardiac disease or advanced liver disease, and onset can occur within hours to days.
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 coadministration where possible and use an alternative antiarrhythmic or HCV regimen. If it is unavoidable, monitor the patient with continuous cardiac monitoring in an inpatient setting for the first 48 hours, then daily heart rate checks for at least the first 2 weeks.
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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