https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=19334

Sofosbuvir / Velpatasvir / Voxilaprevir

Simvastatin

Evaluate risk/benefit ratio.

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 inhibit BCRP and increase the plasma concentration of Simvastatin.

Sofosbuvir / Velpatasvir / Voxilaprevir

Pharmacodynamic effects

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Recommendations

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Alternative solution(s)

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Simvastatin

Pharmacodynamic effects

Possible increase of adverse effects.

Increased risk of myopathy and rhabdomyolysis.

Recommendations

Use this combination with caution.

Use the smallest dose as possible.

Monitor closely for adverse effects.

Alternative solution(s)

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Monitor

Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.

Tests

CK

Lipidic profile

Pharmacokinetic parameters

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Comment

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Reference
  • 3379
    Sofosbuvir/Velpatasvir/Voxilaprevir (VOSEVI), Gilead, Ontario, Canada, 28 janvier 2020.
  • 3430
    Qin S, Seo S, Zheng J, Reynolds K. DDI Liability Evaluation and Risk Management Strategy for Drugs with No Clinical DDI Studies—A story from co-administration of Vosevi with statins. 19th International Workshop on Clinical Pharmacology of Antiviral Therapy. May 22-24 2018, Baltimore, USA, Abstract 45.