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
Velpatasvir solubility drops sharply as gastric pH rises, and proton pump inhibitors lower its exposure. This risks reduced antiviral efficacy and hepatitis C treatment failure.
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.
Why it happens
Higher gastric pH decreases velpatasvir solubility and absorption.
What to do
Avoid coadministration. If a PPI is medically necessary, follow the labeling for the combination, which restricts it to omeprazole 20 mg or equivalent taken 4 hours after sofosbuvir/velpatasvir with food.
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 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. Velpatasvir solubility drops sharply as gastric pH rises, and proton pump inhibitors lower its exposure. This risks reduced antiviral efficacy and hepatitis C treatment failure.
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 coadministration. If a PPI is medically necessary, follow the labeling for the combination, which restricts it to omeprazole 20 mg or equivalent taken 4 hours after sofosbuvir/velpatasvir with food.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
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