Drug interactions
Cimetidine + Ledipasvir / sofosbuvir
Severity: Moderate
Cimetidine and Ledipasvir / sofosbuvir: moderate 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
Ledipasvir dissolves poorly at higher gastric pH, so acid suppression by cimetidine may lower its absorption and potentially reduce antiviral efficacy. The effect is limited at standard H2 blocker doses.
What this interaction means in plain words
Cimetidine and Ledipasvir / sofosbuvir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Higher gastric pH reduces the solubility and absorption of ledipasvir.
What to do
Give the H2 antagonist simultaneously with or 12 hours apart from ledipasvir/sofosbuvir and keep the dose at or below that equivalent to famotidine 40 mg twice daily.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cimetidine and Ledipasvir / sofosbuvir, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Frequently asked questions
Can I take Cimetidine with Ledipasvir / sofosbuvir?
MediHelp rates the interaction as moderate. Cimetidine and Ledipasvir / sofosbuvir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ledipasvir dissolves poorly at higher gastric pH, so acid suppression by cimetidine may lower its absorption and potentially reduce antiviral efficacy. The effect is limited at standard H2 blocker doses.
How serious is the interaction between Cimetidine and Ledipasvir / sofosbuvir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give the H2 antagonist simultaneously with or 12 hours apart from ledipasvir/sofosbuvir and keep the dose at or below that equivalent to famotidine 40 mg twice daily.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine 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.
