From the FDA Drug Label
7 DRUG INTERACTIONS
Table 9 and Table 10 include drugs with clinically important drug interactions and interaction with diagnostics when administered concomitantly with VOQUEZNA and instructions for preventing or managing them These recommendations are based on either drug interaction trials or predicted interactions due to the expected magnitude of interaction and potential for serious adverse reactions or loss of efficacy [see Clinical Pharmacology (12. 3)]. Consult the labeling of concomitantly used drugs to obtain further information about interactions with vonoprazan.
The FDA drug label does not answer the question.
From the Research
There is a potential drug interaction between VELASOF/SOVIHEP V (sofosbuvir/velpatasvir) and vonoprazan, and caution is advised when using these medications together, as vonoprazan may reduce the absorption of velpatasvir, potentially decreasing its effectiveness against hepatitis C virus 1, 2, 3, 4, 5.
Potential Interaction Mechanism
The interaction occurs because velpatasvir requires an acidic environment for optimal absorption, and vonoprazan's strong and prolonged acid suppression can interfere with this process. This interaction is similar to that seen with proton pump inhibitors, though the specific magnitude of effect with vonoprazan may differ.
Management of Potential Interaction
If both medications are necessary, they should be taken at least 4 hours apart, with VELASOF/SOVIHEP V taken before vonoprazan. Alternatively, consider using a different acid-reducing medication with less interaction potential during hepatitis C treatment. Patients should inform their healthcare provider about all medications they are taking to manage potential interactions effectively.
Clinical Implications
The potential interaction between VELASOF/SOVIHEP V and vonoprazan is significant, as it may impact the efficacy of hepatitis C treatment. Healthcare providers should be aware of this potential interaction and take steps to manage it, such as adjusting the timing of medication administration or selecting alternative acid-reducing medications. The safety and efficacy of sofosbuvir/velpatasvir have been established in various clinical trials, including those in patients with compensated cirrhosis and prior treatment failures 4, 5. However, the potential interaction with vonoprazan highlights the importance of careful medication management in patients with hepatitis C.