https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=16248
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=16248
Document made available to the pharmacist to communicate a drug interaction to the doctor.
DOWNLOADOxcarbazepine may induce CYP 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.
Avoid this association. Use with caution if it can not be avoided.
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 or moderate to strong inducers of CYP2B6, 2C8 or 3A4. 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.