https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=16247
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=16247
Document made available to the pharmacist to communicate a drug interaction to the doctor.
DOWNLOADCarbamazepine may induce the metabolism (CYP 2B6, 2C8 and 3A4 and P-gp) and decrease the plasma concentration of Sofosbuvir / Velpatasvir.
Possible decrease of clinical efficacy.
Do not administer with potent P-gp inducers or with moderate to potent CYP2B6, 2C8 or 3A4 inducers.
If it cannot be avoided, use with caution.
Closely monitor clinical effectiveness.
See comments for further details.
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Choose an alternative if possible.
Gabapentin, pregabalin, levetiracetam, brivaracetam, or valproic acid
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TDM levels of DAAs
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The product monograph does not recommend co-administration with strong P-gp and CYP 3A4 inducers. However, a small number of cases have been reported in patients who remained on inducer AEDs during direct-acting antiviral (DAA) therapy for HCV and achieved a sustained virologic response (SVR). These cases appear to demonstrate that clinical cure can still be achieved in patients for whom co-administration cannot be avoided.
Case reports of patients who received standard doses of DDAs against HCV while being maintained on an inducing antiepileptic.
Ref #3710 : Another case report of five patients on anticonvulsant inducers (oxcarbazepine, phenytoin and eslicarbazepine) who started treatment with glecaprevir/pibrentasvir for 8 weeks (n=2), sofosbuvir/velpatasvir for 12 weeks (n=2) or ledipasvir/ sofosbuvir for 12 weeks (n=2). All five patients achieved SVR at 12 weeks. DAAs levels were not measured.
Ref #3711 : Another retrospective case series from six UK centers presents eleven patients on anticonvulsants (carbamazepine, oxcarbazepine, phenobarbital, phenytoin) and treated with standard DAA therapy (sofosbuvir/velpatasvir; n=6, ledipasvir /sofosbuvir; n=3, glecaprevir/pibrentasvir; n=2). RSV results were available for 9 patients (82%) with no virological failure and including one patient who had only completed 50% of his treatment.