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Interactions médicamenteuses

Sofosbuvir-velpatasvir-voxilaprevir + St john's wort

Gravité: Contre-indiquée

Sofosbuvir-velpatasvir-voxilaprevir and St john's wort: contraindicated interaction.

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Résumé

St John's wort induces P-glycoprotein and CYP enzymes, which can substantially reduce exposure to sofosbuvir, velpatasvir and voxilaprevir. This risks subtherapeutic antiviral levels and treatment failure.

Ce que signifie cette interaction, en termes simples

Sofosbuvir-velpatasvir-voxilaprevir and St john's wort 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.

Niveau de preuve: High

Pourquoi elle survient

Induction of P-glycoprotein and CYP3A4/CYP2B6/CYP2C8 by hyperforin reduces absorption and increases metabolism of the HCV drugs.

Conduite à tenir

Avoid the combination; labeling advises against use with St John's wort. Stop the herbal product before starting HCV therapy.

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 Sofosbuvir-velpatasvir-voxilaprevir with St john's wort?

MediHelp rates the interaction as contraindicated. Sofosbuvir-velpatasvir-voxilaprevir and St john's wort 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. St John's wort induces P-glycoprotein and CYP enzymes, which can substantially reduce exposure to sofosbuvir, velpatasvir and voxilaprevir. This risks subtherapeutic antiviral levels and treatment failure.

How serious is the interaction between Sofosbuvir-velpatasvir-voxilaprevir and St john's wort?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; labeling advises against use with St John's wort. Stop the herbal product before starting HCV therapy.

What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?

MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.

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