Drug interactions
Omeprazole + Sofosbuvir-velpatasvir
Severity: Major
Omeprazole and Sofosbuvir-velpatasvir: 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
Omeprazole reduces gastric acidity, and velpatasvir exposure falls substantially when acid is suppressed. This may compromise HCV treatment success. Labeling does not recommend the combination.
What this interaction means in plain words
Omeprazole and Sofosbuvir-velpatasvir 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.
Omeprazole belongs to Gastrointestinal Tract; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Increased gastric pH reduces velpatasvir solubility and absorption.
What to do
Avoid PPIs where possible, or replace them with an H2 blocker. If omeprazole is necessary, give the antiviral with food 4 hours before omeprazole, not exceeding 20 mg daily.
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 Sofosbuvir-velpatasvir
- Rifampin + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Sofosbuvir-velpatasvir + St john's wort Contraindicated
- Amiodarone + Sofosbuvir-velpatasvir Major
- Apalutamide + Sofosbuvir-velpatasvir Major
- Carbamazepine + Sofosbuvir-velpatasvir Major
Other interactions of Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Citalopram + Omeprazole Major
- Clopidogrel + Omeprazole Major
Frequently asked questions
Can I take Omeprazole with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Omeprazole and Sofosbuvir-velpatasvir 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. Omeprazole reduces gastric acidity, and velpatasvir exposure falls substantially when acid is suppressed. This may compromise HCV treatment success. Labeling does not recommend the combination.
How serious is the interaction between Omeprazole and Sofosbuvir-velpatasvir?
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 PPIs where possible, or replace them with an H2 blocker. If omeprazole is necessary, give the antiviral with food 4 hours before omeprazole, not exceeding 20 mg daily.
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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