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Sofosbuvir, velpatasvir, and voxilaprevir (Oral)

soe-FOS-bue-vir, vel-PAT-as-vir, vox-i-LA-pre-vir

Oral route(Tablet)

Test all patients for evidence of current or prior hepatitis B virus (HBV) infection before initiating treatment with sofosbuvir/velpatasvir/voxilaprevir. HBV reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct-acting antivirals and were not receiving HBV antiviral therapy. Some cases have resulted in fulminant hepatitis, hepatic failure, and death. Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV treatment and post-treatment follow-up. Initiate appropriate patient management for HBV infection as clinically indicated .

Medically reviewed on Oct 31, 2018

Commonly used brand name(s)

See also: Harvoni

In the U.S.

  • Vosevi

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antiviral

Pharmacologic Class: Hepatitis C Virus NS5A Inhibitor

Uses For sofosbuvir, velpatasvir, and voxilaprevir

Sofosbuvir, velpatasvir, and voxilaprevir combination is used to treat chronic hepatitis C infection in adults (with or without cirrhosis) who have been previously treated with other medicines.

Sofosbuvir, velpatasvir, and voxilaprevir is available only with your doctor's prescription.

Before Using sofosbuvir, velpatasvir, and voxilaprevir

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sofosbuvir, velpatasvir, and voxilaprevir, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to sofosbuvir, velpatasvir, and voxilaprevir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of sofosbuvir, velpatasvir, and voxilaprevir combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of sofosbuvir, velpatasvir, and voxilaprevir combination in the elderly. However, elderly patients are more sensitive to the effects of sofosbuvir, velpatasvir, and voxilaprevir than younger adults.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sofosbuvir, velpatasvir, and voxilaprevir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using sofosbuvir, velpatasvir, and voxilaprevir with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rifampin

Using sofosbuvir, velpatasvir, and voxilaprevir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amiodarone
  • Atazanavir
  • Bosentan
  • Carbamazepine
  • Cyclosporine
  • Dexamethasone
  • Dexlansoprazole
  • Efavirenz
  • Enzalutamide
  • Esomeprazole
  • Etravirine
  • Fosphenytoin
  • Lansoprazole
  • Lopinavir
  • Lumacaftor
  • Mitotane
  • Modafinil
  • Nafcillin
  • Nevirapine
  • Omeprazole
  • Oxcarbazepine
  • Pantoprazole
  • Phenobarbital
  • Phenytoin
  • Prednisone
  • Primidone
  • Rabeprazole
  • Rifabutin
  • Rifapentine
  • Rosuvastatin
  • St John's Wort
  • Tipranavir
  • Topotecan
  • Warfarin

Using sofosbuvir, velpatasvir, and voxilaprevir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Digoxin
  • Pravastatin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of sofosbuvir, velpatasvir, and voxilaprevir. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart disease or
  • Liver disease, advanced—May increase risk for bradycardia (slow heartbeat).
  • Hepatitis B infection, history of—Use with caution. May cause this disease to become active again.
  • Liver disease, moderate or severe—Sofosbuvir, velpatasvir, and voxilaprevir combination is not recommended in patients with this condition.

Proper Use of sofosbuvir, velpatasvir, and voxilaprevir

Take sofosbuvir, velpatasvir, and voxilaprevir exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Sofosbuvir, velpatasvir, and voxilaprevir should come with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Keep using sofosbuvir, velpatasvir, and voxilaprevir for the full time of treatment, even if you begin to feel better after a few days. Also, it is important to keep the amount of medicine in your body at a steady level. To help keep the amount constant, sofosbuvir, velpatasvir, and voxilaprevir must be used on a regular schedule.

Take sofosbuvir, velpatasvir, and voxilaprevir with food.

If you are taking an antacid containing aluminum or magnesium, take it 4 hours before or after you take sofosbuvir, velpatasvir, and voxilaprevir.

Dosing

The dose of sofosbuvir, velpatasvir, and voxilaprevir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of sofosbuvir, velpatasvir, and voxilaprevir. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For hepatitis C virus infection that has been previously treated with other medicines:
      • Adults—One tablet (400 milligrams [mg] sofosbuvir, 100 mg velpatasvir, 100 mg voxilaprevir) once a day for 12 weeks.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of sofosbuvir, velpatasvir, and voxilaprevir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep sofosbuvir, velpatasvir, and voxilaprevir in its original container.

Precautions While Using sofosbuvir, velpatasvir, and voxilaprevir

It is very important that your doctor check your progress at regular visits to make sure that sofosbuvir, velpatasvir, and voxilaprevir is working properly. Blood tests may be needed to check for unwanted effects.

Do not take sofosbuvir, velpatasvir, and voxilaprevir together with products containing rifampin (eg, Rifadin®, Rifamate®, Rifater®, Rimactane®).

If you have ever had a hepatitis B infection, the virus could become active again during treatment with sofosbuvir, velpatasvir, and voxilaprevir combination. You should be tested for hepatitis B infection before starting treatment with sofosbuvir, velpatasvir, and voxilaprevir. Talk with your doctor if you have concerns.

Amiodarone can cause serious side effects (including cardiac arrest, slow heartbeat, or conditions that need a pacemaker) if used together with sofosbuvir, velpatasvir, and voxilaprevir or other medicines containing sofosbuvir, or if you have used it recently. This is more likely to occur in patients with heart disease or advanced liver disease. Tell your doctor if you are taking amiodarone before using sofosbuvir, velpatasvir, and voxilaprevir.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Sofosbuvir, velpatasvir, and voxilaprevir Side Effects

Along with its needed effects, a medicine 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:

Incidence not known

  • Chest pain or discomfort
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lightheadedness, dizziness, or fainting
  • skin rash, sometimes with blisters or hive-like swelling
  • slow or irregular heartbeat
  • unusual tiredness or weakness

Some side effects 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

  • Diarrhea
  • headache
  • lack or loss of strength
  • nausea

Less common

  • Discouragement
  • feeling sad or empty
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • tiredness
  • trouble concentrating
  • trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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