Drug interactions
Pantoprazole + Sofosbuvir-velpatasvir
Severity: Major
Pantoprazole 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
Pantoprazole suppresses gastric acid and reduces the solubility and absorption of velpatasvir. Antiviral exposure may fall enough to reduce cure rates.
What this interaction means in plain words
Pantoprazole 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.
Pantoprazole belongs to Gastrointestinal Tract; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Elevated gastric pH reduces velpatasvir dissolution and oral absorption.
What to do
Avoid the PPI where possible and use an H2 blocker dosed simultaneously with or 12 hours apart from the antiviral. If a PPI is essential, give the antiviral with food 4 hours before a low-dose PPI and monitor virologic response.
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 Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole Major
Frequently asked questions
Can I take Pantoprazole with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Pantoprazole 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. Pantoprazole suppresses gastric acid and reduces the solubility and absorption of velpatasvir. Antiviral exposure may fall enough to reduce cure rates.
How serious is the interaction between Pantoprazole 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 the PPI where possible and use an H2 blocker dosed simultaneously with or 12 hours apart from the antiviral. If a PPI is essential, give the antiviral with food 4 hours before a low-dose PPI and monitor virologic response.
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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