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Sovaldi Side Effects

Generic Name: sofosbuvir

Note: This document contains side effect information about sofosbuvir. Some of the dosage forms listed on this page may not apply to the brand name Sovaldi.

Some side effects of Sovaldi may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to sofosbuvir: oral tablet

Along with its needed effects, sofosbuvir (the active ingredient contained in Sovaldi) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking sofosbuvir:

More common
  • chills
  • fever
  • lower back or side pain
  • pale skin
  • ulcers, sores, or white spots in the mouth
  • unusual tiredness or weakness
  • Changes in behavior
  • discouragement
  • feeling sad or empty
  • loss of interest or pleasure
  • thoughts of killing oneself
  • trouble concentrating

Some side effects of sofosbuvir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decreased appetite
  • diarrhea
  • difficulty with moving
  • fatigue
  • headache
  • irritability
  • lack or loss of strength
  • muscle aching or cramping
  • muscle pains or stiffness
  • nausea
  • rash or itching skin
  • trouble sleeping

For Healthcare Professionals

Applies to sofosbuvir: oral tablet


Sofosbuvir should be used with ribavirin or peginterferon/ribavirin. The prescribing information for these agents should be consulted for side effects.

The most common side effects reported with sofosbuvir (the active ingredient contained in Sovaldi) and ribavirin therapy were fatigue and headache. The most common side effects reported with sofosbuvir, peginterferon, and ribavirin therapy were fatigue, headache, nausea, insomnia, and anemia. Therapy was permanently discontinued due to side effects in 4% of subjects using placebo, 1% of subjects using sofosbuvir and ribavirin for 12 weeks, less than 1% of subjects using sofosbuvir and ribavirin for 24 weeks, 11% of subjects using peginterferon alfa and ribavirin for 24 weeks, and 2% of subjects using sofosbuvir, peginterferon alfa, and ribavirin for 12 weeks.


Very common (10% or more): Fatigue (up to 59%), asthenia (up to 21%), pyrexia (up to 18%), chills (up to 17%), influenza-like illness (up to 16%)

Nervous system

Very common (10% or more): Headache (up to 36%)


Lipase elevation was isolated and asymptomatic.

Very common (10% or more): Nausea (up to 34%), diarrhea (up to 12%)
Common (1% to 10%): Increased lipase (greater than 3 times upper limit of normal [ULN]: up to 2%)


Very common (10% or more): Pruritus (up to 27%), rash (18%)


Very common (10% or more): Insomnia (up to 25%), irritability (up to 13%)
Uncommon (0.1% to 1%): Severe depression (including suicidal ideation, suicide; less than 1%)

Severe depression was reported, particularly in patients with history of psychiatric illness.


Very common (10% or more): Decreased hemoglobin (less than 10 g/dL: up to 23%), anemia (up to 21%), neutropenia (up to 17%), decreased neutrophils (0.5 to less than 0.75 x 10[9]/L: up to 15%)
Common (1% to 10%): Decreased neutrophils (less than 0.5 x 10[9]/L: up to 5%), decreased hemoglobin (less than 8.5 g/dL: up to 2%)
Uncommon (0.1% to 1%): Decreased platelets (25 to less than 50 x 10[9]/L: up to 1%), pancytopenia (less than 1%)

Pancytopenia was reported, particularly in patients using concomitant pegylated interferon.


Very common (10% or more): Decreased appetite (up to 18%)


Creatine kinase elevation was isolated and asymptomatic.

Very common (10% or more): Myalgia (up to 14%)
Common (1% to 10%): Increased creatine kinase (at least 10 times ULN: up to 2%)


Common (1% to 10%): Increased total bilirubin (greater than 1.5 times ULN: up to 3%)

Bilirubin levels peaked during the first 1 to 2 weeks of therapy then decreased and returned to baseline levels by 4 weeks after therapy. These bilirubin elevations were not associated with transaminase elevations.

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