Drug interactions
Ledipasvir / sofosbuvir + Nizatidine
Severity: Moderate
Ledipasvir / sofosbuvir and Nizatidine: 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 less soluble at higher pH, so acid-reducing agents can lower its levels and potentially reduce antiviral response. Exposure is acceptable at modest H2 blocker doses.
What this interaction means in plain words
Ledipasvir / sofosbuvir and Nizatidine 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 decreases ledipasvir solubility and absorption.
What to do
Give the H2 blocker simultaneously with or 12 hours apart from ledipasvir/sofosbuvir, keeping the dose no higher than a famotidine 40 mg twice daily equivalent.
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 Nizatidine
- Atazanavir + Nizatidine Major
- Dasatinib + Nizatidine Major
- Erlotinib + Nizatidine Major
- Itraconazole + Nizatidine Major
- Ketoconazole + Nizatidine Major
- Nizatidine + Pazopanib Major
Frequently asked questions
Can I take Ledipasvir / sofosbuvir with Nizatidine?
MediHelp rates the interaction as moderate. Ledipasvir / sofosbuvir and Nizatidine 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 less soluble at higher pH, so acid-reducing agents can lower its levels and potentially reduce antiviral response. Exposure is acceptable at modest H2 blocker doses.
How serious is the interaction between Ledipasvir / sofosbuvir and Nizatidine?
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 H2 blocker simultaneously with or 12 hours apart from ledipasvir/sofosbuvir, keeping the dose no higher than a famotidine 40 mg twice daily equivalent.
What other medicines interact with Nizatidine?
MediHelp also lists interactions of Nizatidine with, for example, Atazanavir, Dasatinib, Erlotinib. The full list is on the Nizatidine page.
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