Drug interactions
Ledipasvir-sofosbuvir + Rifabutin
Severity: Major
Ledipasvir-sofosbuvir and Rifabutin: major 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
Rifabutin is an inducer of P-gp and may reduce sofosbuvir and ledipasvir concentrations, compromising cure. Labeling recommends against combining them.
What this interaction means in plain words
Ledipasvir-sofosbuvir and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ledipasvir-sofosbuvir belongs to Anti Virals; Rifabutin belongs to Anti Bacterial.
Why it happens
Rifabutin induces intestinal P-glycoprotein, lowering absorption of sofosbuvir and ledipasvir.
What to do
Avoid coadministration; use an alternative antimycobacterial regimen or defer HCV treatment where possible.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ledipasvir-sofosbuvir
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Ledipasvir-sofosbuvir + Phenobarbital Contraindicated
- Ledipasvir-sofosbuvir + Phenytoin Contraindicated
- Ledipasvir-sofosbuvir + Rifampin Contraindicated
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Ledipasvir-sofosbuvir + St john's wort Contraindicated
Other interactions of Rifabutin
- Cabotegravir + Rifabutin Contraindicated
- Lorlatinib + Rifabutin Contraindicated
- Rifabutin + Voriconazole Contraindicated
- Apixaban + Rifabutin Major
- Axitinib + Rifabutin Major
- Brexpiprazole + Rifabutin Major
Frequently asked questions
Can I take Ledipasvir-sofosbuvir with Rifabutin?
MediHelp rates the interaction as major. Ledipasvir-sofosbuvir and Rifabutin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifabutin is an inducer of P-gp and may reduce sofosbuvir and ledipasvir concentrations, compromising cure. Labeling recommends against combining them.
How serious is the interaction between Ledipasvir-sofosbuvir and Rifabutin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid coadministration; use an alternative antimycobacterial regimen or defer HCV treatment where possible.
What other medicines interact with Ledipasvir-sofosbuvir?
MediHelp also lists interactions of Ledipasvir-sofosbuvir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Ledipasvir-sofosbuvir page.
Full monographs, dosing and an interaction checker in the MediHelp app
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