Coadministration has not been studied. Bisoprolol is metabolised via CYP3A4 and 2D6 and a clinically significant interaction is unlikely as sofosbuvir does not affect CYP enzymes. Sofosbuvir is a prodrug and formation of its active metabolite is unlikely to be affected by comedications. [Note, the European SmPC recommends a maximum of 10 mg in severe hepatic impairment; the US Prescribing Information recommends an initial 2.5 mg in hepatic impairment with caution in further dose titration.]

Coadministration has not been studied. Duloxetine is metabolised via CYP1A2 and 2D6 and a clinically significant interaction is unlikely as sofosbuvir does not affect CYP enzymes. Sofosbuvir is a prodrug and formation of its active metabolite is unlikely to be affected by comedications. [Note, duloxetine is contraindicated in patients with hepatic impairment as concentrations may increase due to decreased clearance of duloxetine.]

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Hyoscine acts predominantly locally and undergoes minimal absorption. Sofosbuvir is a prodrug and formation of its active metabolite is unlikely to be affected by comedications.