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Drug interactions

Levoketoconazole + Sofosbuvir-velpatasvir

Severity: Moderate

Levoketoconazole and Sofosbuvir-velpatasvir: 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

Levoketoconazole is a strong CYP3A4 and P-gp inhibitor and may raise velpatasvir concentrations. The wide safety margin of velpatasvir makes serious effects unlikely, but levoketoconazole also carries QT and hepatotoxicity risk to consider.

What this interaction means in plain words

Levoketoconazole and Sofosbuvir-velpatasvir 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.

Levoketoconazole belongs to Endocrine; Sofosbuvir-velpatasvir belongs to Anti Virals.

Evidence level: Low

Why it happens

Levoketoconazole inhibits CYP3A4 and P-gp, reducing velpatasvir clearance and increasing absorption.

What to do

Monitor liver enzymes and ECG during combined use. No empiric velpatasvir dose change is needed.

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?

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 Levoketoconazole with Sofosbuvir-velpatasvir?

MediHelp rates the interaction as moderate. Levoketoconazole and Sofosbuvir-velpatasvir 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. Levoketoconazole is a strong CYP3A4 and P-gp inhibitor and may raise velpatasvir concentrations. The wide safety margin of velpatasvir makes serious effects unlikely, but levoketoconazole also carries QT and hepatotoxicity risk to consider.

How serious is the interaction between Levoketoconazole and Sofosbuvir-velpatasvir?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor liver enzymes and ECG during combined use. No empiric velpatasvir dose change is needed.

What other medicines interact with Sofosbuvir-velpatasvir?

MediHelp also lists interactions of Sofosbuvir-velpatasvir with, for example, Rifampin, Rifapentine, St john's wort. The full list is on the Sofosbuvir-velpatasvir page.

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