Drug interactions
Sirolimus + Sofosbuvir-velpatasvir
Severity: Moderate
Sirolimus 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
Velpatasvir inhibits P-gp and weakly CYP3A4, which may increase sirolimus concentrations. Sirolimus has a narrow therapeutic index, and higher exposure can cause excess immunosuppression, hyperlipidemia and cytopenias.
What this interaction means in plain words
Sirolimus 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.
Sirolimus belongs to Miscellaneous; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Velpatasvir inhibits intestinal P-gp and CYP3A4, increasing sirolimus absorption and reducing its clearance.
What to do
Check sirolimus trough levels after starting or stopping the antiviral combination and adjust the dose to the target range.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Sirolimus with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as moderate. Sirolimus 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. Velpatasvir inhibits P-gp and weakly CYP3A4, which may increase sirolimus concentrations. Sirolimus has a narrow therapeutic index, and higher exposure can cause excess immunosuppression, hyperlipidemia and cytopenias.
How serious is the interaction between Sirolimus 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: Check sirolimus trough levels after starting or stopping the antiviral combination and adjust the dose to the target range.
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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