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Interactions médicamenteuses

Fosphenytoin + Ledipasvir-sofosbuvir

Gravité: Contre-indiquée

Fosphenytoin and Ledipasvir-sofosbuvir: contraindicated interaction.

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Résumé

Fosphenytoin is converted to phenytoin, a potent inducer of intestinal P-glycoprotein and other enzymes, which can substantially lower sofosbuvir and ledipasvir exposure. This may lead to loss of antiviral efficacy and hepatitis C treatment failure or resistance.

Ce que signifie cette interaction, en termes simples

Fosphenytoin and Ledipasvir-sofosbuvir 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.

Fosphenytoin belongs to Central Nervous System; Ledipasvir-sofosbuvir belongs to Anti Virals.

Niveau de preuve: Moderate

Pourquoi elle survient

Phenytoin induces intestinal P-glycoprotein, reducing absorption and plasma concentrations of sofosbuvir and ledipasvir.

Conduite à tenir

Do not co-administer. Switch to a non-inducing antiepileptic such as levetiracetam before starting the hepatitis C regimen, under neurology guidance.

Questions à poser à votre pharmacien

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Questions fréquentes

Can I take Fosphenytoin with Ledipasvir-sofosbuvir?

MediHelp rates the interaction as contraindicated. Fosphenytoin and Ledipasvir-sofosbuvir 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. Fosphenytoin is converted to phenytoin, a potent inducer of intestinal P-glycoprotein and other enzymes, which can substantially lower sofosbuvir and ledipasvir exposure. This may lead to loss of antiviral efficacy and hepatitis C treatment failure or resistance.

How serious is the interaction between Fosphenytoin and Ledipasvir-sofosbuvir?

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 co-administer. Switch to a non-inducing antiepileptic such as levetiracetam before starting the hepatitis C regimen, under neurology guidance.

What other medicines interact with Ledipasvir-sofosbuvir?

MediHelp also lists interactions of Ledipasvir-sofosbuvir with, for example, Phenobarbital, Phenytoin, Rifampin. The full list is on the Ledipasvir-sofosbuvir page.

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