Vosevi (sofosbuvir / velpatasvir / voxilaprevir)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Vosevi® (sofosbuvir/velpatasvir/voxilaprevir) is a treatment for adults with hepatitis C virus (HCV) who have:1

  • Genotype 1, 2, 3, 4, 5, or 6 and been previously treated with an NS5A inhibitor
  • Genotype 1a or 3 who have been previously treated with sofosbuvir without an NS5A inhibitor

Vosevi has been approved for people with HCV who do not have cirrhosis, as well as those with compensated cirrhosis. It is a direct-acting antiviral (DAA) drug.1

What are the ingredients in Vosevi?

The active ingredients in Vosevi are:1

  • Sofosbuvir
  • Velpatasvir
  • Voxilaprevir

How does Vosevi work?

The active ingredients in Vosevi have different ways of targeting HCV:1

  • Sofosbuvir is a nucleotide analog NS5B polymerase inhibitor. It fights HCV infection by keeping the virus from multiplying in the liver.
  • Velpatasvir is an NS5A inhibitor. NS5A is a key protein HCV needs to multiply. Blocking this protein help stop HCV growth.
  • Voxilaprevir inhibits NS3/4A protease. This enzyme is also needed for the virus to multiply. Blocking this enzyme helps stop HCV growth.

What are the possible side effects of Vosevi?

The most common side effects of Vosevi include:1

Vosevi may cause slowed heart rate (bradycardia). People taking Vosevi with the heart medicine amiodarone (Cordarone®, Nexterone®, Pacerone®) may experience slowed heart rate. In some people, this has led to the need for a pacemaker or death. Tell your doctor right away if you have signs of slowed heart rate, such as fainting, dizziness, or chest pains.1,2

Vosevi has a boxed warning, the strictest warning from the U.S. Food and Drug Administration (FDA). This is because it may worsen or reactivate hepatitis B infection during or after treatment. This may cause serious liver damage, liver failure, or death. People with current or past hepatitis B infection should be monitored during treatment with Vosesvi. Some may also need to be treated for hepatitis B. Before starting treatment with Vosevi, your doctor should check you for hepatitis B infection.1,2

These are not all the possible side effects of Vosevi. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with Vosevi.

Things to know about Vosevi

People taking the drug rifampin (Rifater®, Rifamate®, Rimactane®, and Rifadin®) should not take Vosevi.1,2

People with moderate to severe liver impairment or those with severe or end-stage kidney disease should not take Vosevi.1

Before starting Vosevi, tell your doctor if you have:1

  • Current or previous hepatits B infection
  • Other liver problems
  • Severe kidney disease or treatment with dialysis

There is not enough data to know if Vosevi is safe to take while pregnant or breastfeeding. Before taking Vosevi, tell your doctor if you are pregnant, plan to become pregnant, or breastfeeding.1

Before beginning treatment for HCV, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Vosevi.

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