Lipitor and Sofosbuvir, velpatasvir, and voxilaprevir

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Velpatasvir may increase the blood levels of atorvastatin in some patients. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with atorvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with velpatasvir may increase the plasma concentrations of the HMG-CoA reductase inhibitors atorvastatin and simvastatin. The proposed mechanism has not been delineated but may involve velpatasvir inhibition of the hepatic uptake transporter organic anion transporting polypeptide 1B (OATP1B), and the efflux transporters P-glycoprotein (P-gp), and/or breast cancer resistance protein (BCRP), of which atorvastatin and simvastatin are substrates. The interaction has not been studied specifically with all statins; data are currently available for rosuvastatin. In 18 healthy volunteers, administration of a single 10 mg dose of rosuvastatin with velpatasvir 100 mg once daily increased mean rosuvastatin peak plasma concentration (Cmax) by approximately 2.6-fold and systemic exposure (AUC) by 2.7-fold compared to rosuvastatin administered alone. By contrast, when a single 40 mg dose of pravastatin was given with velpatasvir 100 mg once daily, mean Cmax and AUC of pravastatin increased by just 28% and 35%, respectively. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: The lowest dose of atorvastatin or simvastatin should be used when prescribed with sofosbuvir-velpatasvir, and the dosage titrated cautiously. Pravastatin may be considered as a substitute. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by fever, malaise, and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Lipitor

Generic Name: atorvastatin

Brand name: Lipitor

Synonyms: n.a.

What is Lipitor?

Sofosbuvir, velpatasvir, and voxilaprevir

Generic Name: sofosbuvir / velpatasvir / voxilaprevir

Brand name: Vosevi

Synonyms: Sofosbuvir, Velpatasvir, and Voxilaprevir

What is Sofosbuvir, velpatasvir, and voxilaprevir?