From the Guidelines
I strongly advise against taking naproxen while on Epclusa without consulting your healthcare provider first, due to potential interactions that could increase the risk of liver-related side effects and kidney problems. Epclusa (sofosbuvir/velpatasvir) is used to treat hepatitis C, and naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that could potentially interact with your treatment 1. The concern is that naproxen may increase the risk of liver-related side effects, which is particularly problematic since Epclusa is prescribed for a liver condition. Additionally, both medications can affect kidney function, and using them together might increase the risk of kidney problems.
Some key points to consider when taking Epclusa include:
- The pharmacokinetics of velpatasvir, a component of Epclusa, were studied in HCV-negative patients with severe renal impairment, and the results showed that velpatasvir AUC was 50% higher, although this was not considered clinically relevant 1.
- The safety assessment of sofosbuvir and velpatasvir was based on pooled Phase III data, and the most commonly reported adverse events were headache, fatigue, and nausea, at a similar frequency to placebo-treated patients 1.
- There are some contraindications in relation to co-medications, including potent P-gp or potent CYP inducers, which can decrease sofosbuvir and/or velpatasvir exposure with the potential loss in efficacy 1.
If you need pain relief while on Epclusa, acetaminophen (Tylenol) is generally considered safer for the liver at recommended doses 1. However, even with acetaminophen, you should follow dosing instructions carefully and avoid alcohol. Always inform your hepatologist or prescribing doctor about all medications you're taking, including over-the-counter drugs, to ensure your hepatitis C treatment is as effective and safe as possible.
From the Research
Interaction between Naproxen and Epclusa
There are no research papers to assist in answering this question, as none of the provided studies mention the interaction between Naproxen and Epclusa.
General Information about Naproxen
- Naproxen sodium possesses analgesic, antipyretic, and anti-inflammatory effects 2.
- Adverse effects of naproxen sodium include gastrointestinal effects, precipitation of allergic symptoms, and potential for hepatotoxicity 2.
- Naproxen is contraindicated in patients with known sensitivity and those with heart failure, hypertension, or other conditions associated with fluid retention 2.
Safety Aspects of Naproxen
- A fixed-dose combination formulation of naproxen and esomeprazole (PN400) has been designed to provide sequential delivery of a nonenteric-coated, immediate-release esomeprazole 20 mg mantle followed by an enteric-coated naproxen 500 mg core 3.
- This combination has been shown to result in a significant reduction in gastric ulcers relative to enteric-coated naproxen 3, 4.
- Patients with this combination had significantly better upper gastrointestinal tolerability compared with those treated with enteric-coated naproxen 3.
Alternative Pain Relief Options
- Paracetamol (acetaminophen) is a suitable first-choice analgesic for many adults with mild to moderate acute pain, and is generally well tolerated at recommended doses (≤4 g/day) in healthy adults 5.
- Paracetamol may be preferable to non-steroidal anti-inflammatory drugs (NSAIDs) that are associated with undesirable gastrointestinal, renal, and cardiovascular effects 5.