Drug interactions
Dexlansoprazole + Sofosbuvir-velpatasvir
Severity: Major
Dexlansoprazole and Sofosbuvir-velpatasvir: major interaction.
Last updated Sources: US FDA label
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
Dexlansoprazole raises gastric pH, and velpatasvir solubility falls sharply at higher pH, so absorption and exposure may be reduced. This could reduce antiviral efficacy. Labeling advises against PPI use with this regimen.
What this interaction means in plain words
Dexlansoprazole 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.
Dexlansoprazole belongs to Gastrointestinal Tract; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Acid suppression raises gastric pH, decreasing velpatasvir dissolution and oral absorption.
What to do
Avoid concomitant use and stop or replace the PPI where possible, for example with a lower-dose H2 blocker given at the same time as or 12 hours apart from the antiviral. If a PPI is essential, follow labeling for omeprazole-type dosing with food and specialist supervision.
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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References
Other interactions of Sofosbuvir-velpatasvir
- Rifampin + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Sofosbuvir-velpatasvir + St john's wort Contraindicated
- Amiodarone + Sofosbuvir-velpatasvir Major
- Apalutamide + Sofosbuvir-velpatasvir Major
- Carbamazepine + Sofosbuvir-velpatasvir Major
Other interactions of Dexlansoprazole
- Dexlansoprazole + Mavacamten Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Dexlansoprazole Major
- Atazanavir + Dexlansoprazole Major
- Dacomitinib + Dexlansoprazole Major
- Dasatinib + Dexlansoprazole Major
Frequently asked questions
Can I take Dexlansoprazole with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Dexlansoprazole 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. Dexlansoprazole raises gastric pH, and velpatasvir solubility falls sharply at higher pH, so absorption and exposure may be reduced. This could reduce antiviral efficacy. Labeling advises against PPI use with this regimen.
How serious is the interaction between Dexlansoprazole 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 concomitant use and stop or replace the PPI where possible, for example with a lower-dose H2 blocker given at the same time as or 12 hours apart from the antiviral. If a PPI is essential, follow labeling for omeprazole-type dosing with food and specialist supervision.
What other medicines interact with Sofosbuvir-velpatasvir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir with, for example, Rifampin, Rifapentine, St john's wort. The full list is on the Sofosbuvir-velpatasvir page.
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