Welcome, Guest. Please login or register.
June 22, 2024, 08:33:39 pm

Login with username, password and session length

  • Total Members: 6309
  • Latest: Vicki
  • Total Posts: 55130
  • Total Topics: 4851
  • Online Today: 117
  • Online Ever: 1314
  • (June 22, 2016, 05:23:42 am)
Users Online
Users: 1
Guests: 85
Total: 86


Welcome to the Hep Forums, a round-the-clock discussion area for people who have Fatty Liver Disease, Hepatitis B, C or a co-infection, their friends and family and others with questions about hepatitis and liver health. Check in frequently to read what others have to say, post your comments, and hopefully learn more about how you can reach your own health goals.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.
  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.
  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.
  • Product advertisement (including links); banners; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from the Hep Forum Moderators.
Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: URGENT: Has Anybody Taken Strong Antibiotics WITH Harvoni?  (Read 9927 times)

0 Members and 1 Guest are viewing this topic.

Offline prston

  • Member
  • Posts: 11
URGENT: Has Anybody Taken Strong Antibiotics WITH Harvoni?
« on: June 03, 2018, 12:52:09 pm »
HELP!  I developed a severe complication in my 4th Week of Harvoni that threatens my treatment.  (Started 5th week today.)

Can anybody answer these questions:

1.  Did you take any antibiotics along with Harvoni?  (Specifically, CLINDAMYCIN.)
2.  If so, did you suffer any side effects by taking antibiotics with Harvoni?


In the 3rd week of Harvoni, an abscessed tooth presented itself (along with extreme pain).   A severe gum infection followed.

My family dentist was too spooked to treat me after I mentioned taking Harvoni (he worried about incompatible reactions with his dental meds & Harvoni).  I was pawned off to a Periodontist.

I reported to my Hep C doctor....who immediately sent me to the lab for blood work.

The blood test showed my liver enzymes were nearly normal but my white blood count was 'astronomical'.   He was very concerned.

The Periodontist said he couldn't treat me until the infection was under control.

I was prescribed the antibiotic CLINDAMYCIN 150mg, 2 pills per dose, 3 doses per day.

My Periodontist said he didn't know if the antibiotic or his dosage was compatible with Harvoni.   

I started yesterday.  I woke up today with a bad gut ache (on top of the Harvoni side effect of nausea  :P).

I called Harvoni's Nurse Hotline...and only got a lawyer-like answer saying there was 'no known' issues with that specific antibiotic, but there were no clinical studies testing Harvoni with said antibiotic.   Basically, the answer was:  Gilead didn't really know. 


Thank you, Preston

Offline badbradley

  • Member
  • Posts: 294
Re: URGENT: Has Anybody Taken Strong Antibiotics WITH Harvoni?
« Reply #1 on: June 04, 2018, 12:02:15 am »

   I found this info regarding the drug compatibility issue. Hope it helps

Per  Harvoni prescribing information sheet.
5.3 Risk of Reduced Therapeutic Effect Due to Use with P-gp Inducers
The concomitant use of HARVONI and P-gp inducers (e.g., rifampin, St. John’s wort)
may significantly decrease ledipasvir and sofosbuvir plasma concentrations and may
lead to a reduced therapeutic effect of HARVONI. Therefore, the use of HARVONI with
P-gp inducers (e.g., rifampin or St. John’s wort) is not recommended [see Drug
Interactions (7.2)].


In conclusion, the current in vitro findings show that the antibiotic clindamycin appears to be oxidized primarily by CYP3A4 (Fig. 8). Moreover, it appears that clindamycin does not inhibit the metabolic activity of the following P450 enzymes, CYP1A2, CYP2C9, CYP2C19, CYP2E1, and CYP2D6, and only moderately inhibited CYP3A4. Therefore, given the poor affinity toward the human hepatic cytochrome P450 enzymes tested, clinically important interactions between clindamycin and coadministered drugs, which are metabolized by these enzymes, appear unlikely.


Effects of DAAs on CYP3A4 substrates
Sofosbuvir and ledipasvir are not metabolised by CYP3A4 37. Ledipasvir is slowly metabolised via an unknown mechanism 21 (Table 1). Sofosbuvir and ledipasvir have been tested in healthy volunteers with cyclosporine, tacrolimus, methadone, ethinyl oestradiol, all substrates of CYP3A4, without clinically significant interactions as expected (Tables 3-5) 28, 39, 42.

This is a great tool to have

Summary: Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Clindamycin is metabolised by CYP3A4 but ledipasvir is only a weak inhibitor of intestinal CYP3A4 in vitro.

It appears you've got the all clear.
« Last Edit: June 04, 2018, 12:51:33 am by badbradley »
Geno 1a
Sov/Oly 12wks - relapse
Har/Riba 12wks
Alt-16  Ast-17 SVR - 12
Alt-15  Ast-14 SVR - 24

Offline prston

  • Member
  • Posts: 11
Re: URGENT: Has Anybody Taken Strong Antibiotics WITH Harvoni?
« Reply #2 on: June 04, 2018, 11:52:54 am »
@ BadBradley

Goodness, you provided much better info than my Hep doctor, Periodontist, and the Harvoni Nurse Hotline.

Thanks to your info, I can make an informed decision about taking strong antibiotics with Harvoni.

You put a lot of effort into your answer.  God Bless You for helping a stranger.  You're aces!

With my deepest appreciation, Preston

Online Lynn K

  • Global Moderator
  • Member
  • Posts: 4,545
  • Get tested, get treated, get cured, fight Hep c!
Re: URGENT: Has Anybody Taken Strong Antibiotics WITH Harvoni?
« Reply #3 on: June 04, 2018, 01:12:39 pm »
Great answer badbradley very through!
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!


© 2024 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.