From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
There is no significant drug interaction between VELASOF/SOVIHEP V (sofosbuvir/velpatasvir) and mirtazapine (I assume this is what you meant by "metrizipine"). These medications can generally be taken together without dose adjustments. VELASOF/SOVIHEP V is a direct-acting antiviral combination used to treat hepatitis C, while mirtazapine is an antidepressant. The metabolism pathways of these medications are different enough that they don't significantly interfere with each other. Sofosbuvir is metabolized via pathways that don't substantially overlap with mirtazapine's metabolism, and while velpatasvir uses some CYP enzymes that might theoretically interact with other medications, no clinically significant interaction with mirtazapine has been documented, as seen in studies such as 1.
Key Points to Consider
- The most recent and highest quality study, 1, did not find any significant interactions between sofosbuvir/velpatasvir and various antiretroviral regimens, suggesting a low likelihood of interaction with mirtazapine.
- Sofosbuvir and velpatasvir have been shown to be well-tolerated in clinical trials, with fatigue, headache, and nausea being the most common adverse events, as reported in studies like 2 and 3.
- It's essential to monitor for any unusual side effects when starting these medications together, such as increased sedation or dizziness, and to inform all healthcare providers about all medications being taken to ensure comprehensive medication management.
Clinical Implications
- VELASOF/SOVIHEP V and mirtazapine can be co-administered without dose adjustments, based on the available evidence.
- Patients should be advised to report any new or worsening symptoms to their healthcare provider.
- The lack of significant drug interaction between these medications supports their concurrent use in patients with hepatitis C and depression, improving the management of both conditions.