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Epclusa Disease Interactions

There are 3 disease interactions with Epclusa (sofosbuvir / velpatasvir).

Major

Direct acting antivirals (applies to Epclusa) immunosuppression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Immunodeficiency, Infectious Hepatitis

HBV reactivation has been reported during or after completion of HCV direct-acting antiviral therapy in HCV/HBV-coinfected patients who were not receiving HBV antiviral therapy; some cases resulted in fulminant hepatitis, hepatic failure, and death. Cases have been reported in hepatitis B surface antigen (HBsAg)-positive patients and patients with serologic evidence of resolved HBV infection (i.e., HBsAg negative and hepatitis B core antibody [anti-HBc] positive). HBV reactivation has also been reported in patients using certain immunosuppressant or chemotherapeutic agents; risk of HBV reactivation associated with HCV direct-acting antiviral therapy may be increased in these patients. All patients should be tested for evidence of current or prior HBV infection by measuring HBsAg and anti-HBc before starting HCV direct-acting antiviral therapy. Patients with serologic evidence of current or prior HBV infection should be monitored for clinical and laboratory signs of hepatitis flare or HBV reactivation during HCV therapy and posttherapy follow-up; appropriate patient management for HBV infection should be started as clinically indicated.

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Moderate

Sofosbuvir (applies to Epclusa) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease, Cirrhosis

Sofosbuvir is extensively metabolized in the liver. The safety and efficacy of sofosbuvir as a single agent have not been established in patients with decompensated cirrhosis. No dosage adjustment is required for patients with mild, moderate or severe hepatic impairment (Child-Pugh Class A, B or C).

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Moderate

Sofosbuvir (applies to Epclusa) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

The safety and efficacy of sofosbuvir as a single agent have not been established in patients with severe renal impairment (eGFR less than 30 mL/min/1.73m2) or ESRD requiring hemodialysis. No dosage recommendation can be given for patients with severe renal impairment or ESRD. No dosage adjustment is necessary for patients with mild or moderate renal impairment.

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Epclusa drug interactions

There are 192 drug interactions with Epclusa (sofosbuvir / velpatasvir).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.