Drug interactions
Rabeprazole + Sofosbuvir-velpatasvir
Severity: Major
Rabeprazole 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
Rabeprazole reduces gastric acidity, lowering velpatasvir solubility and absorption. This may result in reduced antiviral efficacy.
What this interaction means in plain words
Rabeprazole 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.
Rabeprazole belongs to Gastrointestinal Tract; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Increased gastric pH decreases velpatasvir dissolution and bioavailability.
What to do
Avoid PPIs where possible, using an H2 blocker as an alternative. If a PPI is required, give the antiviral with food 4 hours before a low-dose PPI and monitor 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 Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole Major
Frequently asked questions
Can I take Rabeprazole with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Rabeprazole 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. Rabeprazole reduces gastric acidity, lowering velpatasvir solubility and absorption. This may result in reduced antiviral efficacy.
How serious is the interaction between Rabeprazole 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, using an H2 blocker as an alternative. If a PPI is required, give the antiviral with food 4 hours before a low-dose PPI and monitor 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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