Drug & supplement interaction

Garlic + Ledipasvir, Sofosbuvir

Ledipasvir, Sofosbuvir brand name: Harvoni.

Moderate Interaction
The bottom line Moderate

Garlic has a moderate interaction with Ledipasvir, Sofosbuvir. Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Garlic and Ledipasvir, Sofosbuvir

Here is the interaction we found between these two, with the evidence behind it.

Moderate

SOFOSBUVIR (Sovaldi)

Theoretically, taking garlic with sofosbuvir might decrease its effectiveness.
Animal research in rats shows that giving aged garlic extract 120 mg/kg orally daily for 14 days decreases the area under the concentration time curve (AUC) after a single sofosbuvir dose of 40 mg/kg by 36%, increases the clearance by 63%, and decreases the plasma concentrations at 1 and 8 hours by 35% and 58%, respectively. This interaction is hypothesized to be due to induction of intestinal P-glycoprotein expression by garlic.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with garlic and Harvoni (ledipasvir/sofosbuvir). Garlic may rev up a transporter in your gut called P-glycoprotein, which acts like a doorway controlling how much of the medicine gets absorbed. If garlic pushes that doorway to work faster, less sofosbuvir may make it into your system. The worry is weaker drug levels, which could give the hepatitis C virus a chance to keep going and make your treatment less effective. That matters a lot, because finishing a full, effective course is how you clear the virus for good.

I want to be honest, though: this comes only from a rat study, not people, so it's theoretical. Concentrated garlic pills are more of a question than garlic in your cooking. Since Harvoni is a time-limited cure, please skip garlic supplements during treatment unless your pharmacist or doctor okays it.

References
  1. Wasef AK, Wahdan SA, Saeed NM, El-Demerdash E. Effects of aged garlic and ginkgo biloba extracts on the pharmacokinetics of sofosbuvir in rats. Biopharm Drug Dispos. 2022;43(4):152-62. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Garlic Also Interacts With Other Medications

Garlic has 988 moderate known drug interactions in our database — the Ledipasvir, Sofosbuvir one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Garlic

Covers the 2,830 medications we’ve checked against Garlic. Pick one to open its full report.

From our Q&A

Questions About Garlic or Ledipasvir, Sofosbuvir

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Garlic or Ledipasvir, Sofosbuvir, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ledipasvir, Sofosbuvir

This page covers Garlic only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ledipasvir, Sofosbuvir page lists 55 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Bitter Melon (moderate), Black Pepper (moderate) and Bulbine Natalensis (moderate).

By severity: 2 major · 37 moderate · 16 minor.

Open the Ledipasvir, Sofosbuvir interaction page

One more smart check

Taking Garlic as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4,118 real supplement products containing Garlic, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Garlic. Your product may carry other ingredients that interact with Ledipasvir, Sofosbuvir too, on top of Garlic — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Garlic and Ledipasvir, Sofosbuvir Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Garlic
Top 5%

#59 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ledipasvir, Sofosbuvir
Top 25%

#551 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Garlic

What is Garlic?

Garlic
  • High blood pressure
  • High cholesterol
  • Heart health
  • Immune support and common cold
  • Antimicrobial uses

Garlic is a common food and supplement that may modestly help with blood pressure and cholesterol, though the evidence is mixed and effects are usually small. It is generally safe in food amounts, but concentrated supplements can cause stomach upset, breath and body odor, and a higher risk of bleeding. Talk with your pharmacist or doctor before taking garlic supplements, especially if you take other medicines.

Read the full Garlic monograph & all interactions
Medication

About Ledipasvir and Sofosbuvir

What Is Ledipasvir and Sofosbuvir Used For?

Brand name: Harvoni

Ledipasvir and sofosbuvir treats chronic hepatitis C virus (HCV) infection in adults and pediatric patients 3 years of age and older. It is approved for HCV genotypes 1, 4, 5, and 6 in patients without cirrhosis or with compensated cirrhosis (mild-to-moderate liver scarring that the liver is still managing), and for genotype 1 with decompensated cirrhosis (advanced liver disease) when used together with ribavirin.

It is also approved for liver transplant recipients with HCV genotype 1 or 4 infection who do not have cirrhosis or have compensated cirrhosis, in combination with ribavirin. Both Harvoni and the generic ledipasvir and sofosbuvir tablets share these indications.

See full Ledipasvir and Sofosbuvir drug information
Keep checking

Other Drugs & Garlic

Browse every other medication we’ve checked against Garlic — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
988Moderate
0Minor
1,841No known interaction
Moderate

988 interactions

Showing 60 of 988 moderate interactions — see all 988 on the Garlic page.

No interaction 1,841 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Garlic and Ledipasvir, Sofosbuvir Together: Common Questions

Can you take Garlic with Ledipasvir, Sofosbuvir?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Garlic and Ledipasvir, Sofosbuvir interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.