Sofosbuvir / Velpatasvir / Voxilaprevir

Rifampin

Contraindicated.

Available pharmaceutical opinion

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

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Mechanism

Rifampin may induce P-gp and CYP450 and decrease the plasma concentration of Sofosbuvir / Velpatasvir / Voxilaprevir.

Sofosbuvir / Velpatasvir / Voxilaprevir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Alternative solution(s)

Rifampin

Pharmacodynamic effects

Recommendations

Contraindicated. Use alternative.

Alternative solution(s)

Monitor

Tests

Pharmacokinetic parameters
Parameters
Reference number
# patients
HCV
Dose
Frequency
AUC
Cmax
Sofosbuvir / Velpatasvir / Voxilaprevir
3379 3379
17/12/12 0/12/24
- -
400/100/100 mg * 0/100/100 mg *
x 1 x 1
- 72%/- 82%/- 73% † NA/+ 46%/+ 691%
- 77%/- 71%/- 9% † NA/+ 28%/+ 1010%
Rifampin
3379 3379
17/12/12 0/12/24
-  
600 mg 600 mg
QD x 1
   
   
Comment

Ref #3379 : * Administered separately in different clinical trials.
† GS-331007: AUC -5% and Cmax + 23%.
Voxilaprevir concentrations may increase with a single dose of rifampin, but decrease with multiple doses of rifampin.

Reference
  • 3379
    Sofosbuvir/Velpatasvir/Voxilaprevir (VOSEVI), Gilead, Ontario, Canada, 18 avril 2018.
  • 3082
    Garrison KL, Wang Y, Brainard DM, Sajwani K, Mathias A et al. The Effect of Rifampin on the Pharmacokinetics of Sofosbuvir in Healthy Volunteers. 65th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD 2014). Boston USA, November 7-11, 2014. Abstract 992.