Metabolic substrate

Sofosbuvir : P-gp, BCRP / Velpastasvir : P-gp, BCRP, OATP1B1/1B3, CYP 2B6, 2C8, 3A4 (in vitro) / Voxilaprevir : P-gp, BCRP, OATP1B1/1B3, CYP 3A4 (in vitro)

Metabolic inducer

–

Metabolic inhibitor

Velpastasvir : P-gp, BCRP, OATP1B1/1B3 and 2B1 / Voxilaprevir : P-gp, BCRP, OATP1B1/1B3

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

–

Alternative solution(s)

–

Metabolic substrate

3A4 (main), 2C8, 1A2, UGT 2B7; Active metabolite: epoxide hydrolase (CBZ-10,11- epoxide)

Metabolic inducer

3A4 and 2B6 (potent), 2C8 and 2C9 (moderate), 2C19, P-gp, UGT and possibly 1A2

Metabolic inhibitor

–

Pharmacodynamic effects

–

Recommendations

Avoid association.

Alternative solution(s)

Gabapentin, pregabalin, levetiracetam, brivaracetam, or valproic acid