Drug interactions
Irinotecan + Sofosbuvir-velpatasvir
Severity: Moderate
Irinotecan and Sofosbuvir-velpatasvir: 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
Velpatasvir may increase exposure to irinotecan and its active metabolite SN-38 through transporter inhibition. This could worsen neutropenia and diarrhea.
What this interaction means in plain words
Irinotecan and Sofosbuvir-velpatasvir 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.
Irinotecan belongs to Oncology; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Velpatasvir inhibits BCRP and OATP1B1, which may reduce efflux and hepatic uptake of irinotecan and SN-38.
What to do
Monitor blood counts and watch for severe diarrhea. Reduce the irinotecan dose or delay chemotherapy if toxicity occurs.
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 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 Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Frequently asked questions
Can I take Irinotecan with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as moderate. Irinotecan and Sofosbuvir-velpatasvir 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. Velpatasvir may increase exposure to irinotecan and its active metabolite SN-38 through transporter inhibition. This could worsen neutropenia and diarrhea.
How serious is the interaction between Irinotecan and Sofosbuvir-velpatasvir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood counts and watch for severe diarrhea. Reduce the irinotecan dose or delay chemotherapy if toxicity occurs.
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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