Drug interactions
Ledipasvir / sofosbuvir + Rabeprazole
Severity: Moderate
Ledipasvir / sofosbuvir and Rabeprazole: 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 suppression by rabeprazole can lower ledipasvir absorption. This may reduce the likelihood of hepatitis C cure.
What this interaction means in plain words
Ledipasvir / sofosbuvir and Rabeprazole 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
Higher gastric pH lowers ledipasvir solubility and absorption.
What to do
Give the PPI simultaneously with ledipasvir/sofosbuvir under fasting conditions, at a dose no higher than omeprazole 20 mg equivalent. Avoid higher PPI doses.
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 Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole Major
Frequently asked questions
Can I take Ledipasvir / sofosbuvir with Rabeprazole?
MediHelp rates the interaction as moderate. Ledipasvir / sofosbuvir and Rabeprazole 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 suppression by rabeprazole can lower ledipasvir absorption. This may reduce the likelihood of hepatitis C cure.
How serious is the interaction between Ledipasvir / sofosbuvir and Rabeprazole?
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 simultaneously with ledipasvir/sofosbuvir under fasting conditions, at a dose no higher than omeprazole 20 mg equivalent. Avoid higher PPI doses.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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