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Drug Interactions between sofosbuvir / velpatasvir and Zantac

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

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Interactions between your drugs

Moderate

raNITIdine velpatasvir

Applies to: Zantac (ranitidine) and sofosbuvir / velpatasvir

ADJUST DOSE: Coadministration of velpatasvir with H2-receptor antagonists may reduce its gastrointestinal absorption. Velpatasvir exhibits pH-dependent solubility, with increased solubility at lower pH. In 60 healthy volunteers, mean velpatasvir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 20% and 19%, respectively, when a single 400 mg-100 mg dose of sofosbuvir-velpatasvir was administered simultaneously with a 40 mg dose of famotidine. When the famotidine dose was given 12 hours before the sofosbuvir-velpatasvir dose, mean velpatasvir Cmax decreased by 13% and AUC decreased by 15%. 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 sofosbuvir-velpatasvir at a dose that does not exceed the equivalent of famotidine 40 mg twice daily.

References

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

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Drug and food interactions

Minor

raNITIdine food

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

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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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