Drug interactions
Sofosbuvir + Tenofovir df
Severity: Moderate
Sofosbuvir and Tenofovir df: 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
When sofosbuvir-containing regimens, particularly with ledipasvir or velpatasvir, are combined with tenofovir DF, tenofovir exposure can rise. This may increase the risk of renal toxicity, especially in patients with existing kidney impairment or other nephrotoxic risk factors. Sofosbuvir alone has little direct effect on tenofovir.
What this interaction means in plain words
Sofosbuvir and Tenofovir df 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.
Why it happens
The mechanism is not clearly established for sofosbuvir alone; increased tenofovir exposure is mainly seen with NS5A inhibitors in combination products, likely via intestinal P-gp inhibition.
What to do
Monitor renal function (creatinine clearance, serum phosphate, urine protein) at baseline and during treatment. Consider tenofovir alafenamide as an alternative in patients with renal risk.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Sofosbuvir and Tenofovir df, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Sofosbuvir
Frequently asked questions
Can I take Sofosbuvir with Tenofovir df?
MediHelp rates the interaction as moderate. Sofosbuvir and Tenofovir df 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. When sofosbuvir-containing regimens, particularly with ledipasvir or velpatasvir, are combined with tenofovir DF, tenofovir exposure can rise. This may increase the risk of renal toxicity, especially in patients with existing kidney impairment or other nephrotoxic risk factors. Sofosbuvir alone has little direct effect on tenofovir.
How serious is the interaction between Sofosbuvir and Tenofovir df?
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 renal function (creatinine clearance, serum phosphate, urine protein) at baseline and during treatment. Consider tenofovir alafenamide as an alternative in patients with renal risk.
What other medicines interact with Sofosbuvir?
MediHelp also lists interactions of Sofosbuvir with, for example, Amiodarone, Apalutamide, Carbamazepine. The full list is on the Sofosbuvir page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
