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Drug Interactions between Iosopan and Vosevi

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

magaldrate velpatasvir

Applies to: Iosopan (magaldrate) and Vosevi (sofosbuvir / velpatasvir / voxilaprevir)

ADJUST DOSING INTERVAL: Concurrent administration of velpatasvir with drugs that elevate gastric pH such as antacids may reduce its gastrointestinal absorption. Velpatasvir exhibits pH-dependent solubility, with increased solubility at lower pH. Drugs that increase gastric pH are expected to decrease the plasma concentration of velpatasvir.

MANAGEMENT: If an antacid is required, the antacid should be taken 4 hours before or 4 hours after administration of sofosbuvir-velpatasvir. The same precaution may be applicable to other drugs with antacid effects.

References

  1. "Product Information. Epclusa (sofosbuvir-velpatasvir)." Gilead Sciences (2016):

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Moderate

velpatasvir voxilaprevir

Applies to: Vosevi (sofosbuvir / velpatasvir / voxilaprevir) and Vosevi (sofosbuvir / velpatasvir / voxilaprevir)

MONITOR: Coadministration with inhibitors of organic anion transporting polypeptides (OATP) 1B1 and/or 1B3 may increase the plasma concentrations of voxilaprevir, which is a substrate of the hepatic uptake transporters. When a single 100 mg dose of voxilaprevir was administered with a single 600 mg dose of the potent OATP 1B1/1B3 inhibitor cyclosporine (n=24), mean voxilaprevir peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 19.0- and 9.4-fold, respectively. Inhibition of P-glycoprotein (P-gp)- and breast cancer resistance protein (BCRP)-mediated intestinal transport and CYP450 3A4-mediated metabolism of voxilaprevir may also contribute to the overall interaction with cyclosporine. The safety of such high levels of voxilaprevir has not been established.

MANAGEMENT: Caution and monitoring are advised when voxilaprevir is used with OATP 1B1 or 1B3 inhibitors.

References

  1. "Product Information. Vosevi (sofosbuvir/velpatasvir/voxilaprevir)." Gilead Sciences (2017):

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Drug and food interactions

Moderate

voxilaprevir food

Applies to: Vosevi (sofosbuvir / velpatasvir / voxilaprevir)

ADJUST DOSING INTERVAL: Administration with food enhances the oral bioavailability of sofosbuvir, velpatasvir, and voxilaprevir. Relative to fasting conditions, mean sofosbuvir systemic exposure (AUC) increased by 64% to 144%, mean velpatasvir AUC increased by 40% to 166%, and mean voxilaprevir AUC increased by 112% to 435% when the combined sofosbuvir/velpatasvir/voxilaprevir formulation is administered with food.

MANAGEMENT: Sofosbuvir/velpatasvir/voxilaprevir should be administered with food.

References

  1. "Product Information. Vosevi (sofosbuvir/velpatasvir/voxilaprevir)." Gilead Sciences (2017):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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