Drug interactions
Esomeprazole + Ledipasvir / sofosbuvir
Severity: Moderate
Esomeprazole 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 is more soluble in acidic conditions, so acid suppression can lower its absorption and potentially reduce antiviral efficacy. The effect depends on the PPI dose and timing relative to the antiviral.
What this interaction means in plain words
Esomeprazole 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
Elevated gastric pH reduces ledipasvir solubility and bioavailability.
What to do
Give the PPI at a dose not exceeding an omeprazole-equivalent of 20 mg daily, taken simultaneously with ledipasvir/sofosbuvir under fasting conditions. Avoid higher PPI doses where possible.
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?
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Other interactions of Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
Frequently asked questions
Can I take Esomeprazole with Ledipasvir / sofosbuvir?
MediHelp rates the interaction as moderate. Esomeprazole 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 is more soluble in acidic conditions, so acid suppression can lower its absorption and potentially reduce antiviral efficacy. The effect depends on the PPI dose and timing relative to the antiviral.
How serious is the interaction between Esomeprazole 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 PPI at a dose not exceeding an omeprazole-equivalent of 20 mg daily, taken simultaneously with ledipasvir/sofosbuvir under fasting conditions. Avoid higher PPI doses where possible.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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