Interactions between Epclusa and Semaglutide

The sofosbuvir in Epclusa has a moderate potential interaction with Cirrhosis.

Sofosbuvir is extensively metabolized in the liver. The safety and efficacy of sofosbuvir as a single agent have not been established in patients with decompensated cirrhosis. No dosage adjustment is required for patients with mild, moderate or severe hepatic impairment (Child-Pugh Class A, B or C).

Semaglutide has a moderate potential interaction with Dehydration.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

Semaglutide has a moderate potential interaction with Diabetic Retinopathy.

Patients with history of diabetic retinopathy should be monitored for progression of diabetic retinopathy during treatment with semaglutide. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy.

Semaglutide has a moderate potential interaction with Diarrhea.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

Semaglutide has a moderate potential interaction with Gastroparesis.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

The sofosbuvir in Epclusa has a major potential interaction with Immunodeficiency.

HBV reactivation has been reported during or after completion of HCV direct-acting antiviral therapy in HCV/HBV-coinfected patients who were not receiving HBV antiviral therapy; some cases resulted in fulminant hepatitis, hepatic failure, and death. Cases have been reported in hepatitis B surface antigen (HBsAg)-positive patients and patients with serologic evidence of resolved HBV infection (i.e., HBsAg negative and hepatitis B core antibody [anti-HBc] positive). HBV reactivation has also been reported in patients using certain immunosuppressant or chemotherapeutic agents; risk of HBV reactivation associated with HCV direct-acting antiviral therapy may be increased in these patients. All patients should be tested for evidence of current or prior HBV infection by measuring HBsAg and anti-HBc before starting HCV direct-acting antiviral therapy. Patients with serologic evidence of current or prior HBV infection should be monitored for clinical and laboratory signs of hepatitis flare or HBV reactivation during HCV therapy and posttherapy follow-up; appropriate patient management for HBV infection should be started as clinically indicated.

The sofosbuvir in Epclusa has a major potential interaction with Infectious Hepatitis.

HBV reactivation has been reported during or after completion of HCV direct-acting antiviral therapy in HCV/HBV-coinfected patients who were not receiving HBV antiviral therapy; some cases resulted in fulminant hepatitis, hepatic failure, and death. Cases have been reported in hepatitis B surface antigen (HBsAg)-positive patients and patients with serologic evidence of resolved HBV infection (i.e., HBsAg negative and hepatitis B core antibody [anti-HBc] positive). HBV reactivation has also been reported in patients using certain immunosuppressant or chemotherapeutic agents; risk of HBV reactivation associated with HCV direct-acting antiviral therapy may be increased in these patients. All patients should be tested for evidence of current or prior HBV infection by measuring HBsAg and anti-HBc before starting HCV direct-acting antiviral therapy. Patients with serologic evidence of current or prior HBV infection should be monitored for clinical and laboratory signs of hepatitis flare or HBV reactivation during HCV therapy and posttherapy follow-up; appropriate patient management for HBV infection should be started as clinically indicated.

The sofosbuvir in Epclusa has a moderate potential interaction with Liver Disease.

Sofosbuvir is extensively metabolized in the liver. The safety and efficacy of sofosbuvir as a single agent have not been established in patients with decompensated cirrhosis. No dosage adjustment is required for patients with mild, moderate or severe hepatic impairment (Child-Pugh Class A, B or C).

Semaglutide has a major potential interaction with Multiple Endocrine Neoplasia Type II.

The use semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. It is recommended to counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors.

The sofosbuvir in Epclusa has a moderate potential interaction with Renal Dysfunction.

The safety and efficacy of sofosbuvir as a single agent have not been established in patients with severe renal impairment (eGFR less than 30 mL/min/1.73m2) or ESRD requiring hemodialysis. No dosage recommendation can be given for patients with severe renal impairment or ESRD. No dosage adjustment is necessary for patients with mild or moderate renal impairment.

Semaglutide has a major potential interaction with Thyroid Tumor.

The use semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. It is recommended to counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors.

Semaglutide has a moderate potential interaction with Vomiting.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.