https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=13542

Ledipasvir / Sofosbuvir

Phenobarbital

Not recommended association.

Available pharmaceutical opinion

Document made available to the pharmacist to communicate a drug interaction to the doctor.

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Mechanism

Phenobarbital may induce P-gp and decrease the plasma concentration of Ledipasvir / Sofosbuvir.

Ledipasvir / Sofosbuvir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

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Alternative solution(s)

–

Phenobarbital

Pharmacodynamic effects

–

Recommendations

Avoid association. Choose an alternative.

See comments.

Alternative solution(s)

Gabapentin, pregabalin, valproic acid, clobazam, leviracetam, topiramate, lacosamide or lamotrigine.

Monitor

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Tests

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Pharmacokinetic parameters

–

Comment

Ref #3524 : Case report of five patients who received standard doses for the treatment of chronic hepatitis C infection while being maintained on first generation anticonvulsants (carbamazepine, phenobarbital, phenytoin). Four patients were treated with glecaprevir/pibrentasvir for 8 weeks and one patient with ledipasvir/sofosbuvir for 12 weeks. All five patients achieved a sustained virologic response (SVR) despite this drug interaction. The authors conclude that all efforts to prevent concomitant use with strong inducers should be made.

Reference
  • 3073
    Ledipasvir/Sofosbuvir (Harvoni), Gilead, Ontario, Canada, 16 avril 2018.
  • 3524
    Natali KM, Jimenez HR, and J Slim. When Coadministration Cannot Be Avoided: Real World Experience of Direct Acting Antivirals for the Treatment of Hepatitis C Virus Infection in Patients on First Generation Anticonvulsants. Journal of Pharmacy Practice. December 15, 2020; 897190020977762.