Drug interactions
Apalutamide + Ledipasvir-sofosbuvir
Severity: Major
Apalutamide 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
Apalutamide is an inducer of several enzymes and transporters, including P-gp and BCRP. It may lower exposure to ledipasvir and sofosbuvir, which are P-gp and BCRP substrates, and risk reduced antiviral efficacy.
What this interaction means in plain words
Apalutamide 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.
Apalutamide belongs to Endocrine; Ledipasvir-sofosbuvir belongs to Anti Virals.
Why it happens
Apalutamide induces P-gp and BCRP, increasing efflux and reducing absorption of ledipasvir and sofosbuvir.
What to do
Avoid the combination where possible, since reduced antiviral exposure may compromise cure. If unavoidable, monitor HCV viral response closely.
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 Ledipasvir-sofosbuvir
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Ledipasvir-sofosbuvir + Phenobarbital Contraindicated
- Ledipasvir-sofosbuvir + Phenytoin Contraindicated
- Ledipasvir-sofosbuvir + Rifampin Contraindicated
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Ledipasvir-sofosbuvir + St john's wort Contraindicated
Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Frequently asked questions
Can I take Apalutamide with Ledipasvir-sofosbuvir?
MediHelp rates the interaction as major. Apalutamide 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. Apalutamide is an inducer of several enzymes and transporters, including P-gp and BCRP. It may lower exposure to ledipasvir and sofosbuvir, which are P-gp and BCRP substrates, and risk reduced antiviral efficacy.
How serious is the interaction between Apalutamide 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 the combination where possible, since reduced antiviral exposure may compromise cure. If unavoidable, monitor HCV viral response closely.
What other medicines interact with Ledipasvir-sofosbuvir?
MediHelp also lists interactions of Ledipasvir-sofosbuvir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Ledipasvir-sofosbuvir page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
