Drug General Information (ID: DDI3SG5YPX)
Drug Name			Esomeprazole		Drug Info		Velpatasvir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiulcer Agents				Antiviral Agents
Structure

Mechanism of Esomeprazole-Velpatasvir Interaction (Severity Level: Major)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Esomeprazole				Velpatasvir
Mechanism		Gastric alkalinizer				Gastric pH sensitive
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Velpatasvir due to altered gastric pH caused by Esomeprazole

Recommended Action
Management		Concomitant use of sofosbuvir-velpatasvir with proton-pump inhibitors should generally be avoided. If coadministration is required, sofosbuvir-velpatasvir should be administered with food and taken 4 hours before the proton-pump inhibitor at a maximum daily dose equivalent to omeprazole 20 mg. Use with other proton-pump inhibitors has not been studied.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Epclusa (sofosbuvir-velpatasvir). Gilead Sciences, Foster City, CA.