Background: Sofosbuvir is a direct-acting antiviral drug used to treat chronic hepatitis C
infection. In 2015, Gilead Sciences, the manufacturer of sofosbuvir, warned that bradycardia could
occur when sofosbuvir is administered in combination with amiodarone. Interestingly, among the reported
cases of patients with sofosbuvir and amiodarone related bradycardia, some of them were also
treated with propranolol.
Objective: We herein report a case of ventricular extrasystoles within three hours after the coadministration
of sofosbuvir-containing regimen with propranolol. This patient had never been treated with
amiodarone. After the sofosbuvir-containing regimen was stopped, ventricular extrasystoles disappeared
within 24 hours. This observation suggests that the association of sofosbuvir with propranolol
may have a role in the emergence of cardiac arrhythmia.
Conclusion: Patients treated with amiodarone and/or propranolol should be continuously monitored
within the early hours following the initiation of sofosbuvir.