Ledipasvir/Tegobuvir/Vedroprevir + Verapamil = Precautionary

Effect on Concentration

Ledipasvir/Tegobuvir/Vedroprevir
Increase
Applies within class?
No
Verapamil
No change
Applies within class?
No

Pharmacologic Effects

Ledipasvir/Tegobuvir/Vedroprevir
Effect
N/A
Applies within class?
No
Verapamil
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 09-Jul-2018

Summary

Sources

Investigational nucleoside and nucleotide polymerase inhibitors and their use in treating hepatitis C virus. ^

Study Design

The drug-drug interaction potential of ledipasvir (LDV) in combination with vedroprevir (VDV) and tegobuvir (TGV) with verapamil was evaluated.

Study Results

Co-administration of LDV/VDV/TGV and verapamil resulted in ~2-fold higher AUC and ~1.6-fold higher Cmax of VDV, ~1.5 - 1.7-fold higher AUC of LDV, and 1.3-1.4-fold higher AUC of TGV. The Cmax for LDV and TGV remained comparable to reference treatments.

Study Conclusions

Dose adjustment may be warranted when administering VDV with P-gp inhibitors. The authors state that LDV and TGV may be co-administered with verapamil, considering that their increased exposure when co-administered with verapamil was modest, however, close monitoring is recommended.

References

Gentile I, Coppola N, Buonomo AR, Zappulo E, Borgia G. Investigational nucleoside and nucleotide polymerase inhibitors and their use in treating hepatitis c virus. Expert Opinion On Investigational Drugs. 2014; 9: 1211-1223.