藥物交互作用
Carbamazepine + Sofosbuvir-velpatasvir
嚴重程度: 嚴重
Carbamazepine and Sofosbuvir-velpatasvir: major interaction.
最後更新
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摘要
Carbamazepine is a potent inducer of P-glycoprotein and of several CYP enzymes, and it can substantially lower plasma concentrations of sofosbuvir and velpatasvir. This may lead to loss of antiviral activity and treatment failure or resistance. The combination is not recommended in labeling.
用白話說明這項交互作用的意義
Carbamazepine and Sofosbuvir-velpatasvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Carbamazepine belongs to Central Nervous System; Sofosbuvir-velpatasvir belongs to Anti Virals.
為什麼會發生
Carbamazepine induces P-gp and CYP2B6, CYP2C8 and CYP3A4, increasing clearance and reducing absorption of sofosbuvir and velpatasvir.
處置方式
Avoid the combination and switch to an anticonvulsant without enzyme-inducing activity, such as levetiracetam, if clinically possible. If it cannot be avoided, consult a hepatology or infectious disease specialist and confirm sustained virologic response.
可向藥師詢問的問題
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Sofosbuvir-velpatasvir 的其他交互作用
Carbamazepine 的其他交互作用
常見問題
Can I take Carbamazepine with Sofosbuvir-velpatasvir?
MediHelp rates the interaction as major. Carbamazepine and Sofosbuvir-velpatasvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Carbamazepine is a potent inducer of P-glycoprotein and of several CYP enzymes, and it can substantially lower plasma concentrations of sofosbuvir and velpatasvir. This may lead to loss of antiviral activity and treatment failure or resistance. The combination is not recommended in labeling.
How serious is the interaction between Carbamazepine and Sofosbuvir-velpatasvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and switch to an anticonvulsant without enzyme-inducing activity, such as levetiracetam, if clinically possible. If it cannot be avoided, consult a hepatology or infectious disease specialist and confirm sustained virologic response.
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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