Harvoni (ledipasvir/sofosbuvir) is a prescription drug that’s used to treat hepatitis C. This drug can interact with other medications and some supplements. For example, Harvoni can interact with amiodarone and St. John’s wort.
Harvoni is used in adults and certain children to treat hepatitis C. It comes as an oral tablet. Harvoni is also available as pellets that you can swallow or sprinkle on food.
Harvoni contains the active ingredients* ledipasvir and sofosbuvir. Harvoni isn’t available as a generic drug.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Harvoni’s possible interactions. And for more information about Harvoni, including details about its uses, see this article.
* An active ingredient is what makes a drug work.
Certain health conditions or other factors could raise your risk of harm if you take Harvoni. In such cases, your doctor may not prescribe Harvoni for you. One example is described below.
If you’ve had an allergic reaction. If you’ve had an allergic reaction to Harvoni or any of its ingredients, your doctor likely won’t prescribe Harvoni. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
There’s no known interaction between Harvoni and alcohol.
However, drinking alcohol while taking Harvoni could raise your risk of side effects from Harvoni. It could also make your side effects more severe. Examples of these side effects include headache and fatigue (low energy).
In addition, both hepatitis C (the condition Harvoni is used to treat) and excessive alcohol consumption can cause serious liver problems, including cirrhosis (scarring). Due to this risk, your doctor may suggest avoiding alcohol during your Harvoni treatment.
If you have questions about consuming alcohol while taking Harvoni, talk with your doctor.
Before you start taking Harvoni, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Harvoni interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Harvoni?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Harvoni. Keep in mind that this table does not include all drugs that may interact with Harvoni. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug type or drug name | Drug examples | What can happen |
| drugs that increase activity of the P-gp* protein | • rifampin (Rimactane) • apalutamide (Erleada) | can make Harvoni less effective |
| drugs that reduce stomach acid | • famotidine (Pepcid) • omeprazole (Prilosec) | can make Harvoni less effective |
| certain statin drugs | • atorvastatin (Lipitor) • rosuvastatin (Crestor) | can increase the risk of side effects of the statin drug |
| certain antiretroviral drugs | • tipranavir (Aptivus) • ritonavir (Norvir) • tenofovir disoproxil fumarate | can make Harvoni less effective orcan increase the risk of side effects from the antiretroviral drugs |
| amiodarone (Pacerone) | — | can increase the risk of side effects from amiodarone |
| digoxin (Lanoxin) | — | can increase the risk of side effects from digoxin |
*P-gp helps transport a drug around your body after you take a dose.
Learn more about certain drug interactions that can occur with Harvoni.
Interaction with drugs that increase activity of the P-gp protein
Harvoni interacts with drugs that increase the activity of the P-gp protein. This is a protein that helps transport a drug throughout your body after you take a dose.
Examples of drugs that increase the activity of the P-gp protein include:
- rifampin (Rimactane)
- apalutamide (Erleada)
- carbamazepine (Tegretol, others)
- phenytoin (Dilantin)
- primidone (Mysoline)
What could happen
Taking Harvoni with a drug that increases the activity of P-gp may lower the amount of Harvoni in your body. This can make the drug less effective.
What you can do
Taking Harvoni with a drug that speeds up the activity of the P-gp protein is not recommended. Instead, your doctor will likely suggest an alternative to Harvoni or to the other medication.
Interaction with certain antiretroviral drugs
Harvoni interacts with certain antiretroviral drugs, which are used to treat HIV.
Examples of antiretroviral medications that interact with Harvoni include:
- tipranavir (Aptivus)
- ritonavir (Norvir)
- tenofovir disoproxil fumarate (Viread), including treatments that contain this drug, such as tenofovir disoproxil fumarate/elvitegravir/cobicistat/emtricitabine (Stribild)
What could happen
Taking Harvoni with some antiretroviral drugs can make Harvoni less effective. And with certain other antiretroviral drugs, combining them with Harvoni may increase the risk of side effects from the antiretroviral drug.
What you can do
Before you begin taking Harvoni, tell your doctor and pharmacist if you’re taking an antiretroviral drug. They can check if the antiretroviral drug interacts with Harvoni. In some cases, your doctor may need to monitor you closely for side effects during your treatment.
Your doctor will likely avoid prescribing tipranavir (Aptivus) or ritonavir (Norvir) with Harvoni, as taking Harvoni with these drugs can make Harvoni less effective. Your doctor can discuss an alternative treatment option for HIV and hepatitis C with you.
Interaction with drugs that reduce stomach acid
Harvoni can interact with drugs that lower your level of stomach acid.
Drugs that reduce stomach acid are used to treat heartburn and indigestion (upset stomach). They’re also used in some instances to treat conditions that cause these symptoms, including gastroesophageal reflux disease (GERD).
Examples of medications that lower stomach acid levels include:
- antacids, such as calcium carbonate (Tums)
- H2-receptor blockers, such as famotidine (Pepcid) and cimetidine (Tagamet)
- proton pump inhibitors, such as omeprazole (Prilosec) and esomeprazole (Nexium)
What could happen
After you take a dose of Harvoni, your body needs to have a certain amount of stomach acid for the drug to be absorbed correctly. Taking a drug that reduces stomach acid can make Harvoni less effective. This may mean that Harvoni doesn’t completely treat your hepatitis C, or it could also make your hepatitis C resistant to Harvoni.
What you can do
If you need to take Harvoni with a drug that reduces your stomach acid, your doctor will likely suggest separating your doses of these drugs by at least 4 hours. If you have questions, talk with your doctor or pharmacist.
Harvoni may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Harvoni.
Does Harvoni interact with supplements?
Before you start taking Harvoni, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Harvoni interactions with herbs
Harvoni interacts with the herbal supplement St. John’s wort, which is used to ease symptoms of depression and other conditions.
St. John’s wort increases the activity of the P-gp protein.* This protein helps transport a drug throughout your body after you take a dose. Taking Harvoni with St. John’s wort can lower the amount of Harvoni in your body, which can make the drug less effective.
Your doctor will likely advise that you do not take Harvoni with St. John’s wort. If you’re prescribed Harvoni, your doctor can recommend alternatives to St. John’s wort.
If you have questions about Harvoni and possible interactions with herbs, talk with your doctor or pharmacist.
* To learn more about Harvoni’s interaction with P-gp, see the “Drug interactions explained” section above.
Harvoni and vitamins
There are currently no reports of Harvoni interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Harvoni.
Does Harvoni interact with food?
There are currently no reports of Harvoni interacting with food. If you have questions about eating certain foods during your treatment with Harvoni, talk with your doctor.
Does Harvoni interact with vaccines?
Harvoni isn’t known to interact with vaccines.
Talk with your doctor or pharmacist if you have questions about receiving vaccines while taking Harvoni.
Does Harvoni interact with lab tests?
Harvoni isn’t known to interact with the results of any lab tests.
If you have questions about having lab tests done while taking Harvoni, talk with your doctor.
Does Harvoni interact with cannabis or CBD?There are currently no reports of Harvoni interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Harvoni.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Harvoni. Before taking Harvoni, talk with your doctor about your health history. They’ll determine whether Harvoni is right for you.
Health conditions or other factors that might interact with Harvoni include:
Severe kidney problem and liver cirrhosis. It’s not known whether it’s safe to take Harvoni if you have both a severe kidney problem (including receiving kidney dialysis) and decompensated cirrhosis (liver problems due to scarring of the liver). If you have kidney problems but not decompensated cirrhosis, Harvoni is likely safe for you to take. Your doctor can determine whether Harvoni is safe for you based on your specific health factors.
Hepatitis B virus (HBV) infection. Harvoni has a
Pregnancy. It’s not known whether it’s safe to take Harvoni while pregnant. If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of taking Harvoni.
Breastfeeding. It isn’t known whether it’s safe to take Harvoni while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking Harvoni.
Allergic reaction. If you’ve had an allergic reaction to Harvoni or any of its ingredients, your doctor will likely not prescribe Harvoni. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Harvoni. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Harvoni treatment.
It’s also important to understand Harvoni’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Harvoni exactly as prescribed can also help prevent interactions.
If you still have questions about Harvoni and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- While I’m taking Harvoni, should I let you know if I make lifestyle changes, such as to my diet or exercise routine?
- If I take Harvoni and have certain health conditions, will I be monitored more closely during treatment?
- Because Harvoni treatment is short-term, is it safe to take St. John’s wort again once I finish taking Harvoni?
To learn more about Harvoni, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.