Drug reference

Ledipasvir

Antiviral

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Possible risk of neonatal goitre; use only if no

FDA category + note

Top interactionssee all 12 →

AntacidsSevereTextbookG&G 14e · p1238, p1242
Domperidone + OmeprazoleSevereTextbookG&G 14e · p1238, p1242
H2 Receptor AntagonistsSevereTextbookG&G 14e · p1238, p1242
Pantoprazole + DomperidoneSevereTextbookG&G 14e · p1238, p1242

Mechanism

The provided textbook excerpts mention Ledipasvir in the context of drug-drug interactions and safety warnings, particularly regarding concurrent use with amiodarone or with elvitegravir. However, these excerpts do not detail the specific molecular mechanism of action, molecular target, or affected pathway of Ledipasvir itself.

Indications

HCV genotypes 1, 4, 5, and 6 (as part of fixed-dose combination with sofosbuvir)Decompensated cirrhosis (as part of fixed-dose combination with sofosbuvir, often with ribavirin)

Dosing

Adult: ▶ INITIALLY BY INTRAVENOUS INJECTION ▶ Adult: Initially 300 mg, dose to be considered after administration of adrenaline, dose should be given from a pre-ﬁlled syringe or diluted in 20 mL Glucose 5%, then (by intravenous injection) 150 mg if required, followed by (by intravenous infusion) 900 mg/24 hours IMPORTANT SAFETY INFORMATION MHRA/CHM ADVICE: SOFOSBUVIR WITH DACLATASVIR; SOFOSBUVIR AND LEDI…
Pediatric: Weight-based dosing (as part of LDV/SOF) for children 3 years or older with HCV genotypes 1, 4, 5, or 6

Pharmacokinetics

Half-life

47 h

Bioavailability

Unknown in humans (30%–50% in animals)

Protein binding

Greater than 99.8% bound to human plasma proteins

Metabolism

Approximately 30% metabolized via uncertain pathways

Excretion

Primarily eliminated unchanged in the feces

Contraindications

Individuals with an eGFR less than 30 mL/min/1.73 m2 (as part of LDV/SOF combination)
Concomitant use with potent P-gp inducers (e.g., rifampin, St. John’s wort, phenytoin, carbamazepine)

Side effects

Common

FatigueHeadache

Serious

Severe bradycardia and heart block (when taken with amiodarone in combination with sofosbuvir)

Pregnancy & lactation

Pregnancy

Possible risk of neonatal goitre; use only if no

Drug interactions

Antacids

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If antacids must be used, separate administration by 4 hours. Follow specific dosing instructions for H2 blockers (max 40 mg famotidine BID) and PPIs (max 20 mg omeprazole QD, administered simultaneously with LDV/SOF in fasted state).

Source: G&G 14e · p1238, p1242

Domperidone + Omeprazole

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If PPIs must be used, their doses should not exceed the equivalent of 20 mg omeprazole once daily. Omeprazole must be administered simultaneously with LDV/SOF in the fasted state.

Source: G&G 14e · p1238, p1242

H2 Receptor Antagonists

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If H2 blockers must be used, their doses should not exceed the equivalent of 40 mg famotidine twice daily.

Source: G&G 14e · p1238, p1242

Pantoprazole + Domperidone

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If PPIs must be used, their doses should not exceed the equivalent of 20 mg omeprazole once daily. Omeprazole must be administered simultaneously with LDV/SOF in the fasted state.

Source: G&G 14e · p1238, p1242

Pariet

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If PPIs must be used, their doses should not exceed the equivalent of 20 mg omeprazole once daily. Omeprazole must be administered simultaneously with LDV/SOF in the fasted state.

Source: G&G 14e · p1238, p1242

Potent Bcrp Inducers

Severe

Textbook

Reduced ledipasvir concentrations and efficacy.

Cannot be used with potent BCRP inducers (e.g., rifampin, St. John’s wort, phenytoin, carbamazepine). Avoid combination.

Source: G&G 14e · p1238

Potent P Gp Inducers

Severe

Textbook

Reduced ledipasvir concentrations and efficacy.

Cannot be used with potent P-gp inducers (e.g., rifampin, St. John’s wort, phenytoin, carbamazepine). Avoid combination.

Source: G&G 14e · p1238, p1242

Rabeprazole + Domperidone

Severe

Textbook

Reduced ledipasvir concentrations, potentially leading to treatment failure/relapse.

If PPIs must be used, their doses should not exceed the equivalent of 20 mg omeprazole once daily. Omeprazole must be administered simultaneously with LDV/SOF in the fasted state.

Source: G&G 14e · p1238, p1242

Colchicine

Severe

Database

Drug interaction classified as: excretion

Source: DDInter

Edoxaban

Severe

Database

Clinical effect not specified

Source: DDInter

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