Drug interactions
Dabigatran + Ledipasvir-sofosbuvir
Severity: Major
Dabigatran 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
Ledipasvir inhibits intestinal P-gp and can raise exposure to dabigatran etexilate, increasing bleeding risk. The risk is greater in patients with renal impairment.
What this interaction means in plain words
Dabigatran 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.
Why it happens
P-gp inhibition increases absorption of dabigatran etexilate.
What to do
Avoid the combination if CrCl is below 30 mL/min (below 50 mL/min for DVT/PE treatment); otherwise monitor for bleeding and renal function.
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
Frequently asked questions
Can I take Dabigatran with Ledipasvir-sofosbuvir?
MediHelp rates the interaction as major. Dabigatran 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. Ledipasvir inhibits intestinal P-gp and can raise exposure to dabigatran etexilate, increasing bleeding risk. The risk is greater in patients with renal impairment.
How serious is the interaction between Dabigatran 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 if CrCl is below 30 mL/min (below 50 mL/min for DVT/PE treatment); otherwise monitor for bleeding and renal function.
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.
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