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Ravidasvir is a weak inhibitor of organic anion transporting polypeptide (OATP) 1B1 and 1B3 and of CYP3A, CYP2C19, and UGT1A1. Clinically meaningful interactions are not expected between Ravida and substrates of BCRP, OATP, CYP enzymes or UGT1A1.
Potential for other medicinal products to affect ravidasvir: Ravidasvir is a substrate of the drug transporter P-glycoprotein (P-gp). Medicinal products that are strong inducers of P-gp (e.g. carbamazepine, phenobarbital, phenytoin, rifampicin, rifabutin and St. John's wort) may decrease plasma concentrations of ravidasvir leading to reduced therapeutic effect of Ravida. The use of such medicinal products with Ravida is contraindicated (see Contraindications).
Medicinal products that are moderate P-gp inducers (e.g. oxcarbazepine or rifapentine) may decrease ravidasvir plasma concentration leading to reduced therapeutic effect of Ravida. Co-administration of Ravida with moderate P-gp inducers is not recommended (see Precautions).
Co-administration with medicinal products that inhibit P-gp may increase ravidasvir plasma concentrations. However, clinically meaningful interactions with P-gp inhibitors are not expected.
Patients treated with vitamin K antagonists: As liver function may change during treatment with ravidasvir, close monitoring of International Normalised Ratio (INR) values is recommended.
Interactions between Ravida and other medicinal products: Table 10 provides a listing of established or potentially clinically relevant medicinal product interactions. The interactions described are based on studies conducted with ravidasvir or are predicted medicinal product interactions that may occur with ravidasvir. The direction of the arrow indicates the direction of change of the exposures. Observed or predicted changes are shown as ↑ =increase, ↓ = decrease, ↔ = no change. The table is not all-inclusive. (See Table 10.)
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