The highest documented doses of ledipasvir and sofosbuvir were 120 mg twice daily for 10 days and a single dose of 1,200 mg, respectively, with no untoward effects observed at these dose levels, and adverse reactions similar in frequency and severity to those reported in the placebo groups. The effects of higher doses are not known.
No specific antidote is available for overdose with ZIFAM SOVIR PLUS. If overdose occurs the patient must be monitored for evidence of toxicity. Treatment of overdose with ZIFAM SOVIR PLUS consists of general supportive measures including monitoring of vital signs as well as observation of the clinical status of the patient. Haemodialysis is unlikely to result in significant removal of ledipasvir as ledipasvir is highly bound to plasma protein. Haemodialysis can efficiently remove the predominant circulating metabolite of sofosbuvir, GS-331007, with an extraction ratio of 53%.