The concomitant use of ledipasvir/sofosbuvir and P-gp inducers (e.g., rifampin, St. John’s wort) may significantly decrease both ledipasvir and sofosbuvir plasma concentrations and may lead to a reduced therapeutic effect of the combination. Therefore, the use of ledipasvir/sofosbuvir with P-gp inducers (e.g., rifampin or St. John’s wort) is not recommended.
Proton-pump inhibitor doses comparable to omeprazole >20 mg or lower should not be administered simultaneously with ledipasvir/sofosbuvir.
Coadministration of ledipasvir/sofosbuvir with rosuvastatin may significantly increase the concentration of rosuvastatin, which is associated with increased risk of myopathy, including rhabdomyolysis. Coadministration of ledipasvir/sofosbuvir with rosuvastatin is not recommended.