Drug interactions
Elbasvir / grazoprevir + Sofosbuvir-velpatasvir
Severity: Major
Elbasvir / grazoprevir 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
Velpatasvir inhibits OATP1B1/1B3 and may increase grazoprevir exposure, which is associated with ALT elevations. Both are HCV regimens, and their combination is not recommended as it offers no benefit and may increase hepatic risk.
What this interaction means in plain words
Elbasvir / grazoprevir 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
Velpatasvir inhibits hepatic OATP1B1/1B3 uptake of grazoprevir, raising its plasma concentrations.
What to do
Avoid combining two HCV direct-acting antiviral regimens. Choose one complete regimen.
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 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
Frequently asked questions
Can I take Elbasvir / grazoprevir with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Elbasvir / grazoprevir 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. Velpatasvir inhibits OATP1B1/1B3 and may increase grazoprevir exposure, which is associated with ALT elevations. Both are HCV regimens, and their combination is not recommended as it offers no benefit and may increase hepatic risk.
How serious is the interaction between Elbasvir / grazoprevir 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 combining two HCV direct-acting antiviral regimens. Choose one complete regimen.
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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