Methadone/sofosbuvir/velpatasvir/tamsulosin interaction
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Facial and bilateral lower extremity oedema following drug interaction: case report A 46-year-old man developed facial and bilateral lower extremity oedema following a concomitant administration of sofosbuvir/ velpatasvir, methadone and tamsulosin. The man, with hepatitis C virus (HCV) infection and dysuria for 1 week, presented for HCV therapy assessment in September 2018. He had a history of drug abuse, and had been receiving methadone maintenance therapy. Additionally, he received tamsulosin [tamsulosin hydrochloride] intermittently for benign prostatic hypertrophy during the past 3 years. Subsequently, he started receiving sofosbuvir/velpatasvir 400/100mg (fixed dose) as a singlet tablet once daily for 12 weeks. At week 8 of treatment, he received oral tamsulosin 0.2 mg/day for dysuria [not all dosages and routes stated]. However, 48 hours post tamsolosin administration, he was hospitalised due to progressive bilateral lower extremity oedema and facial oedema, which did not change with posture. He underwent high-resolution doppler ultrasound of the arteries and veins of the lower limbs, which revealed no flow alterations. Also, his echocardiogram revealed normal ejection fraction and diastolic function. The man’s therapy with tamsolosin was discontinued immediately, and treated with furosemide and spironolactone. His oedema dissipated gradually following treatment and disappeared 10 days later. He re-initiated tamsulosin following antiviral treatment; however, no signs of oedema were observed. It was noted that velpatasvir and tamsulosin resulted in an increased effective concentration of methadone. This increased effective concentration of methadone led to the development of facial and bilateral lower extremity oedema [not all time to reactions onsets stated]. Li Y-P, et al. Facial and bilateral lower extremity edema due to drug-drug interactions in a patient with hepatitis C virus infection and benign prostate hypertrophy: A case report. World Journal of Clinical Cases 8: 3372-3376, No. 15, 6 Aug 2020. Available from: URL: http://doi.org/10.12998/WJCC.V8.I15.3372 803502116
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Reactions 19 Sep 2020 No. 1822
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