A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation

The advent of direct-acting antiviral agents (DAA) allows for the utilization of hepatitis C (HCV) viremic donors to uninfected recipients. Sofosbuvir/velpatasvir (SOF/VEL) is a pangenotypic DAA without clinically significant interactions with immunosuppressants, but its concomitant use with amiodar...

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Main Authors: Ryan M. Rivosecchi, Pablo G. Sanchez, Lauren M. Sacha, Edward T. Horn, Mary Keebler, Fernanda P. Silveira
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:JHLT Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950133425000746
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author Ryan M. Rivosecchi
Pablo G. Sanchez
Lauren M. Sacha
Edward T. Horn
Mary Keebler
Fernanda P. Silveira
author_facet Ryan M. Rivosecchi
Pablo G. Sanchez
Lauren M. Sacha
Edward T. Horn
Mary Keebler
Fernanda P. Silveira
author_sort Ryan M. Rivosecchi
collection DOAJ
description The advent of direct-acting antiviral agents (DAA) allows for the utilization of hepatitis C (HCV) viremic donors to uninfected recipients. Sofosbuvir/velpatasvir (SOF/VEL) is a pangenotypic DAA without clinically significant interactions with immunosuppressants, but its concomitant use with amiodarone may cause serious bradycardia. In an open-label study of 20 heart and lung transplant recipients of organs from HCV viremic donors, who received SOF/VEL for 12 weeks starting on post-operative day one, the concomitant use of amiodarone and SOF/VEL resulted in bradycardic episodes and commonly occurred in the presence of beta-blocking medications. Episodes of bradycardia were transient, resolved with intervention, and did not require the discontinuation of SOF/VEL. In patients requiring the combination of SOF/VEL and amiodarone, consideration of therapeutic options is warranted prior to the addition of other bradycardia-inducing medications.
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publisher Elsevier
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series JHLT Open
spelling doaj-art-d21c074e78fa485a9116ade5ac384c852025-08-20T03:02:59ZengElsevierJHLT Open2950-13342025-08-01910027910.1016/j.jhlto.2025.100279A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantationRyan M. Rivosecchi0Pablo G. Sanchez1Lauren M. Sacha2Edward T. Horn3Mary Keebler4Fernanda P. Silveira5Department of Pharmacy, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213Department of Cardiothoracic Surgery, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213Department of Pharmacy, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213Department of Pharmacy, UPMC Presbyterian, 200 Lothrop St., Pittsburgh, PA 15213; Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 550 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15213Department of Medicine, Division of Cardiology, University of Pittsburgh, 200 Lothrop St C-700, Pittsburgh, PA 15213Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, 3601 Fifth Avenue Suite 5B, Pittsburgh, PA 15213; Corresponding author: Fernanda P. Silveira, Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA 15213.The advent of direct-acting antiviral agents (DAA) allows for the utilization of hepatitis C (HCV) viremic donors to uninfected recipients. Sofosbuvir/velpatasvir (SOF/VEL) is a pangenotypic DAA without clinically significant interactions with immunosuppressants, but its concomitant use with amiodarone may cause serious bradycardia. In an open-label study of 20 heart and lung transplant recipients of organs from HCV viremic donors, who received SOF/VEL for 12 weeks starting on post-operative day one, the concomitant use of amiodarone and SOF/VEL resulted in bradycardic episodes and commonly occurred in the presence of beta-blocking medications. Episodes of bradycardia were transient, resolved with intervention, and did not require the discontinuation of SOF/VEL. In patients requiring the combination of SOF/VEL and amiodarone, consideration of therapeutic options is warranted prior to the addition of other bradycardia-inducing medications.http://www.sciencedirect.com/science/article/pii/S2950133425000746Hepatitis CAmiodaroneBradycardiaHeart transplantLung transplant
spellingShingle Ryan M. Rivosecchi
Pablo G. Sanchez
Lauren M. Sacha
Edward T. Horn
Mary Keebler
Fernanda P. Silveira
A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
JHLT Open
Hepatitis C
Amiodarone
Bradycardia
Heart transplant
Lung transplant
title A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
title_full A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
title_fullStr A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
title_full_unstemmed A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
title_short A single center experience of concomitant administration of sofosbuvir/velpatasvir and amiodarone after heart and lung transplantation
title_sort single center experience of concomitant administration of sofosbuvir velpatasvir and amiodarone after heart and lung transplantation
topic Hepatitis C
Amiodarone
Bradycardia
Heart transplant
Lung transplant
url http://www.sciencedirect.com/science/article/pii/S2950133425000746
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