Harvoni interactions: Alcohol, medications, and other factors

Before you start treatment with Harvoni, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Harvoni interacts with supplements, herbs, or vitamins, see the “Harvoni and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Harvoni. Keep in mind that this table doesn’t include all drugs that may interact with Harvoni. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* Harvoni may also interact with sodium bicarbonate (baking soda) supplements, which can be used as antacids. For details, see the “Harvoni and other interactions” section below.
† For details about this interaction, see the “Drug interactions in depth” section below.
‡ To learn about Harvoni’s side effects, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing a drug due to the risk of harm. These are known as contraindications.

There are no known Harvoni contraindications. However, certain health conditions or other factors may increase the risk of interactions with Harvoni. For details, see the “Harvoni and health-related interactions” section below.

You can also talk with your doctor or pharmacist.

There aren’t any known interactions between Harvoni and alcohol. However, your doctor may advise you to limit or avoid alcohol consumption during Harvoni treatment.

This is because drinking alcohol while taking the drug may worsen some of Harvoni’s side effects. For example, you may have worsened fatigue, headache, or nausea.

Alcohol can also worsen hepatitis C, which Harvoni is prescribed to treat.

If you have questions about avoiding or limiting alcohol while taking Harvoni, talk with your doctor.

Here’s a closer look at certain drug interactions of Harvoni.

H2 blockers

H2 blockers are used to ease symptoms of conditions such as heartburn and indigestion.

Interaction result: Taking Harvoni with an H2 blocker could make Harvoni less effective.

Interaction explained: H2 blockers may affect your body’s ability to absorb Harvoni. This can lower the level of Harvoni in your body, making the drug less effective for treating hepatitis C.

Examples of H2 blocker drugs: Here are some H2 blockers that may interact with Harvoni:

• nizatidine (Axid AR)
• famotidine (Pepcid AC)
• cimetidine (Tagamet HB)

Steps you or your doctor may take: Before taking an H2 blocker during Harvoni treatment, talk with your doctor. They can recommend ways to take these medications together safely.

For example, your doctor may recommend taking the H2 blocker at least 12 hours before or after your Harvoni dosage. Alternatively, they may suggest taking both medications at the same time or taking a lower dose of the H2 blocker altogether. Any of these options can help reduce the risk of the H2 blocker affecting Harvoni.

To learn more about taking Harvoni with H2 blockers, talk with your doctor or pharmacist.

Prednisone

Prednisone (Rayos) is a corticosteroid prescribed for many conditions involving inflammation. Examples include allergic conditions and skin conditions, such as eczema.

Interaction result: Taking Harvoni with prednisone may increase the risk of side effects from prednisone.

Interaction explained: Harvoni may block the activity of a specific protein that helps move prednisone through your body after a dose. This effect can result in a high level of prednisone in your system, increasing your risk of side effects from the drug.

Steps you or your doctor may take: Before taking prednisone with Harvoni, talk with your doctor. They can advise whether it’s safe to take these medications together, or if a different corticosteroid may be prescribed instead.

To learn more about taking Harvoni with prednisone, talk with your doctor or pharmacist.

Amiodarone

Amiodarone (Nexterone, Pacerone) is prescribed for certain irregular heart rhythms.

Interaction result: Taking Harvoni with amiodarone can increase the risk of slow heart rate.

Interaction explained: Harvoni may increase the heart rate-lowering effect of amiodarone. This can result in a severely low heart rate that may be life threatening or require surgery to insert a heart pacemaker. In extreme cases, the heart may suddenly stop beating.

Steps you or your doctor may take: Before starting Harvoni treatment, tell your doctor if you’re taking amiodarone. They can recommend whether it’s safe to take these medications together.

If your doctor prescribes Harvoni and amiodarone together, they may monitor your heart rate in the hospital for at least 48 hours. They may continue watching your heart rate closely during the first two weeks of taking these medications together. Likewise, if you stop taking amiodarone right before starting Harvoni treatment, your doctor may also monitor your heart rate closely.

To learn more about taking Harvoni with amiodarone, talk with your doctor or pharmacist.

Harvoni may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Harvoni.

Harvoni interactions with supplements

Harvoni may interact with sodium bicarbonate (baking soda) supplements, which can be used as antacids. Taking Harvoni with these supplements could make Harvoni less effective for hepatitis C.

Your doctor can recommend whether it’s safe to take sodium bicarbonate supplements during Harvoni treatment. If they tell you it’s safe, they may advise you to take the supplement at least 4 hours before or after your Harvoni dosage. Doing so may help prevent these supplements from affecting Harvoni.

Before you start treatment with Harvoni, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Harvoni interactions with herbs

Harvoni may interact with St. John’s wort, which is an herbal supplement used for depression and other conditions.

St. John’s wort may speed up the activity of an enzyme (a type of protein) in your body that helps break down Harvoni. This can lead to a low level of Harvoni in your system, making the drug less effective for treating hepatitis C.

Due to this risk, doctors will typically recommend avoiding St. John’s wort during Harvoni treatment. They may be able to suggest a treatment option other than St. John’s wort.

Harvoni and vitamins

There are no specific reports of vitamins interacting with Harvoni. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Harvoni.

Harvoni and food

Although sodium bicarbonate (baking soda) supplements may interact with Harvoni, there were no reports of food interactions with the drug. The amount of baking soda in food, such as baked goods, is usually much less than what’s in a sodium bicarbonate supplement.

It’s also important to avoid sprinkling Harvoni oral pellets onto acidic foods such as fruit and cheese. Instead, you’ll sprinkle the pellets onto nonacidic foods, such as pudding and mashed potatoes. To learn more about taking Harvoni, see this article.

If you have additional questions or want more information about eating certain foods during Harvoni treatment, talk with your doctor.

Harvoni and vaccines

There aren’t any known interactions between Harvoni and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Harvoni and lab tests

Harvoni isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

HARVONI AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Harvoni. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Harvoni. The impact of cannabis may affect how well you stick to your Harvoni treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Harvoni. Before you take this drug, be sure to talk with your doctor about your health history. Harvoni may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Harvoni include:

• Mental health conditions: In rare cases, Harvoni may increase the risk of suicidal thoughts and behaviors in people who have mental health conditions. If you have a mental health condition, your doctor can advise whether Harvoni is a safe treatment option.
• Allergic reaction: If you’ve had an allergic reaction to Harvoni or any of its ingredients, your doctor will likely not prescribe Harvoni. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to take Harvoni while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Harvoni may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Harvoni. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Harvoni is safe to take while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting Harvoni. They can advise you on the right treatment plan for you.
• Risk of reactivation of hepatitis B virus (HBV): Harvoni has a boxed warning about the risk of reactivation of HBV. For details, see the boxed warning at the top of this article.

You can take certain steps to help prevent interactions with Harvoni. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Harvoni label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Harvoni doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Harvoni by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.