Drug interactions
Rifampin + Sofosbuvir-velpatasvir
Severity: Contraindicated
Rifampin and Sofosbuvir-velpatasvir: contraindicated 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
Rifampin is a potent inducer of P-gp and CYP enzymes and markedly reduces sofosbuvir and velpatasvir exposure. Coadministration risks HCV treatment failure and is not recommended in labeling.
What this interaction means in plain words
Rifampin and Sofosbuvir-velpatasvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Rifampin potently induces P-gp and CYP2B6, CYP2C8 and CYP3A4, greatly increasing antiviral clearance.
What to do
Do not coadminister; defer HCV therapy until rifampin is completed, or use an alternative antibacterial regimen.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Sofosbuvir-velpatasvir
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Sofosbuvir-velpatasvir + St john's wort Contraindicated
- Amiodarone + Sofosbuvir-velpatasvir Major
- Apalutamide + Sofosbuvir-velpatasvir Major
- Carbamazepine + Sofosbuvir-velpatasvir Major
- Dabrafenib + Sofosbuvir-velpatasvir Major
Frequently asked questions
Can I take Rifampin with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as contraindicated. Rifampin and Sofosbuvir-velpatasvir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Rifampin is a potent inducer of P-gp and CYP enzymes and markedly reduces sofosbuvir and velpatasvir exposure. Coadministration risks HCV treatment failure and is not recommended in labeling.
How serious is the interaction between Rifampin and Sofosbuvir-velpatasvir?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not coadminister; defer HCV therapy until rifampin is completed, or use an alternative antibacterial regimen.
What other medicines interact with Sofosbuvir-velpatasvir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir with, for example, Rifapentine, St john's wort, Amiodarone. The full list is on the Sofosbuvir-velpatasvir page.
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