What is the drug interaction between Velpatasvir/Sofosbuvir (VELASOF) / Sofosbuvir (SOVIHEP V) and Domperidone (Domperidone)?

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Last updated: April 15, 2025View editorial policy

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From the Research

I strongly advise against using domperidone with VELASOF or SOVIHEP V (sofosbuvir/velpatasvir combinations) due to potential drug interactions that can increase the risk of serious cardiac side effects. The provided evidence does not directly address the interaction between domperidone and sofosbuvir/velpatasvir combinations. However, based on the general principles of pharmacology, it is known that sofosbuvir and velpatasvir can inhibit P-glycoprotein (P-gp) transporters in the body, which can lead to increased blood levels of P-gp substrates like domperidone 1, 2, 3, 4, 5.

Potential Risks

  • Increased domperidone blood levels can lead to serious cardiac side effects, including QT prolongation and arrhythmias.
  • The interaction occurs because sofosbuvir/velpatasvir combinations can block the transport proteins that normally help eliminate domperidone from the body, causing it to accumulate to potentially dangerous levels.

Safer Alternatives

  • If an antiemetic is needed while on VELASOF or SOVIHEP V therapy, consider safer alternatives like ondansetron or metoclopramide after consulting with your healthcare provider.
  • Always inform your healthcare provider about all medications you are taking before starting hepatitis C treatment to avoid harmful drug interactions.

Key Considerations

  • The most recent and highest quality study on sofosbuvir/velpatasvir combinations is from 2022, which highlights the efficacy and safety of this treatment regimen in patients with chronic hepatitis C virus infection 3.
  • While the provided evidence does not directly address the interaction between domperidone and sofosbuvir/velpatasvir combinations, the general principles of pharmacology suggest that this interaction can occur.
  • As a precautionary measure, it is recommended to avoid using domperidone with VELASOF or SOVIHEP V (sofosbuvir/velpatasvir combinations) to minimize the risk of serious cardiac side effects.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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