Drug interactions
Sofosbuvir / velpatasvir + Topotecan
Severity: Moderate
Sofosbuvir / velpatasvir and Topotecan: 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 BCRP and P-gp, and topotecan is a substrate of both transporters. Exposure to topotecan may rise, increasing the risk of myelosuppression and gastrointestinal toxicity.
What this interaction means in plain words
Sofosbuvir / velpatasvir and Topotecan 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
Velpatasvir inhibits BCRP and P-gp efflux transporters, increasing topotecan absorption and reducing its elimination.
What to do
Avoid oral topotecan during velpatasvir therapy; for IV topotecan monitor blood counts closely and reduce dose if toxicity occurs.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
Frequently asked questions
Can I take Sofosbuvir / velpatasvir with Topotecan?
MediHelp rates the interaction as moderate. Sofosbuvir / velpatasvir and Topotecan 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 BCRP and P-gp, and topotecan is a substrate of both transporters. Exposure to topotecan may rise, increasing the risk of myelosuppression and gastrointestinal toxicity.
How serious is the interaction between Sofosbuvir / velpatasvir and Topotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid oral topotecan during velpatasvir therapy; for IV topotecan monitor blood counts closely and reduce dose if toxicity occurs.
What other medicines interact with Topotecan?
MediHelp also lists interactions of Topotecan with, for example, Adenovirus types 4 and 7 live, Amiodarone, Cisplatin. The full list is on the Topotecan page.
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