Drug interactions
Ledipasvir-sofosbuvir + Topotecan
Severity: Major
Ledipasvir-sofosbuvir and Topotecan: 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
Ledipasvir may increase topotecan exposure, particularly oral topotecan, raising the risk of myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Ledipasvir-sofosbuvir and Topotecan 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; Topotecan belongs to Oncology.
Why it happens
Ledipasvir inhibits P-gp and possibly BCRP, increasing topotecan absorption and reducing its elimination.
What to do
Avoid with oral topotecan; with IV topotecan, monitor blood counts closely and consider dose reduction.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
Frequently asked questions
Can I take Ledipasvir-sofosbuvir with Topotecan?
MediHelp rates the interaction as major. Ledipasvir-sofosbuvir and Topotecan 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 may increase topotecan exposure, particularly oral topotecan, raising the risk of myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Ledipasvir-sofosbuvir and Topotecan?
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 with oral topotecan; with IV topotecan, monitor blood counts closely and consider dose reduction.
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.
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