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Drug interactions

Ledipasvir-sofosbuvir + Phenytoin

Severity: Contraindicated

Ledipasvir-sofosbuvir and Phenytoin: contraindicated 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

Phenytoin is an inducer of P-gp and CYP enzymes and is expected to substantially reduce ledipasvir and sofosbuvir exposure. This can cause failure of hepatitis C therapy. Labeling advises against use together.

What this interaction means in plain words

Ledipasvir-sofosbuvir and Phenytoin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Ledipasvir-sofosbuvir belongs to Anti Virals; Phenytoin belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Phenytoin induces P-glycoprotein and metabolic enzymes, reducing absorption and exposure of sofosbuvir and ledipasvir.

What to do

Do not coadminister; replace phenytoin with a non-inducing antiepileptic before and during HCV treatment.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Ledipasvir-sofosbuvir with Phenytoin?

MediHelp rates the interaction as contraindicated. Ledipasvir-sofosbuvir and Phenytoin are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Phenytoin is an inducer of P-gp and CYP enzymes and is expected to substantially reduce ledipasvir and sofosbuvir exposure. This can cause failure of hepatitis C therapy. Labeling advises against use together.

How serious is the interaction between Ledipasvir-sofosbuvir and Phenytoin?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; replace phenytoin with a non-inducing antiepileptic before and during HCV treatment.

What other medicines interact with Ledipasvir-sofosbuvir?

MediHelp also lists interactions of Ledipasvir-sofosbuvir with, for example, Fosphenytoin, Phenobarbital, Rifampin. The full list is on the Ledipasvir-sofosbuvir page.

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