Drug interactions
Riociguat + Sofosbuvir-velpatasvir
Severity: Moderate
Riociguat and Sofosbuvir-velpatasvir: moderate 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
Riociguat is a BCRP and P-gp substrate, and velpatasvir inhibits both transporters. Higher exposure may cause hypotension.
What this interaction means in plain words
Riociguat and Sofosbuvir-velpatasvir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Riociguat belongs to Cardiovascular; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Velpatasvir inhibits BCRP and P-gp efflux of riociguat, increasing its plasma concentrations.
What to do
Monitor blood pressure and consider a lower riociguat starting dose.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Riociguat with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as moderate. Riociguat and Sofosbuvir-velpatasvir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Riociguat is a BCRP and P-gp substrate, and velpatasvir inhibits both transporters. Higher exposure may cause hypotension.
How serious is the interaction between Riociguat and Sofosbuvir-velpatasvir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and consider a lower riociguat starting dose.
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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