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Drug Interactions between ledipasvir / sofosbuvir and ranitidine

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

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Interactions between your drugs

Moderate

raNITIdine ledipasvir

Applies to: ranitidine and ledipasvir / sofosbuvir

ADJUST DOSE: Coadministration of ledipasvir with H2-receptor antagonists may reduce its gastrointestinal absorption. Ledipasvir exhibits pH-dependent solubility, with increased solubility at lower pH. In 12 healthy volunteers, mean ledipasvir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 20% and 11%, respectively, when a single 90 mg-400 mg dose of ledipasvir-sofosbuvir was administered simultaneously with a 40 mg dose of famotidine. When the famotidine dose was given 12 hours before the ledipasvir-sofosbuvir dose, mean ledipasvir Cmax decreased by 17% and AUC decreased by just 2%. These alterations are not considered clinically significant. However, higher dosages of famotidine or another H2-receptor antagonist may result in a greater magnitude of interaction.

MANAGEMENT: H2-receptor antagonists may be administered simultaneously with or 12 hours apart from ledipasvir-sofosbuvir at a dose that does not exceed the equivalent of famotidine 40 mg twice daily.

References (1)
  1. (2014) "Product Information. Harvoni (ledipasvir-sofosbuvir)." Gilead Sciences

Drug and food interactions

Minor

raNITIdine food

Applies to: ranitidine

H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.

References (1)
  1. Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM (1990) "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol, 38, p. 165-9

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.

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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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