Sofosbuvir / Velpatasvir / Voxilaprevir

Digoxin

Use with caution.

Available pharmaceutical opinion

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

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Mechanism

Sofosbuvir / Velpatasvir / Voxilaprevir can decrease the P-gp and increase the plasma concentration of Digoxin.

Sofosbuvir / Velpatasvir / Voxilaprevir

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Digoxin

Pharmacodynamic effects

Possible increase of adverse effects.

Recommendations

Use this combination with caution.

Monitor for development of adverse effects and adjust dosage if necessary.

Alternative solution(s)

Monitor

Adverse effects of digoxin: Gastrointestinal effects (abdominal discomfort, nausea/vomiting, diarrhea, anorexia, dyspepsia), central nervous system effects, vision disorders, fatigue, headache, bradycardia and rhythm disorders.

EKG

Tests

Digoxinemia

Pharmacokinetic parameters

Comment

Ref #3379 : Coadministration with sofosbuvir/velpatasvir/voxilaprevir has not been studied. In 21 healthy subjects, concomitant administration of a single dose of digoxin 0.25 mg with velpatasvir 100 mg QD increased digoxin AUC and Cmax by 34% and 88%, respectively.

Reference
  • 3379
    Sofosbuvir/Velpatasvir/Voxilaprevir (VOSEVI), Gilead, Ontario, Canada, 18 avril 2018.