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Ledipasvir / Sofosbuvir may inhibit hepatic transports OATP1B1/B3 and BCRP and increase plasma concentration of Rosuvastatin.
Ledipasvir : P-gp and BCRP; primarily excreted (>98%) unchanged in the feces, with little renal excretion, P-gp / Sofosbuvir : P-gp and BCRP; rapidly converted to the predominant circulating metabolite GS-331007 that accounts for greater than 90% of drug related material systemic exposure.
Ledipasvir : P-gp and BCRP (intestinal weak), OATP1B1/1B3, BSEP and UGT1A1 (hepatic only at doses higher than those obtained in the clinic)
OATP1B1, OATP1B3 and BCRP
Possible increase of adverse effects.
Association not recommended.
Choose an alternative.
If deemed clinically possible, discontinue treatment with statin during the taking of ledipasvir/sofosbuvir.
Statin without interaction with all of the medication.
Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.
Ref #3129: a pharmacokinetic study showed an increase of rosuvastatin AUC by 8-fold (+699%) and Cmax by 17.7-fold (+1670%) when co-administered with the GS-9451/ledipasvir/tegobuvir.