Vosevi (sofosbuvir/velpatasvir/voxilaprevir)

Vosevi® (sofosbuvir/velpatasvir/voxilaprevir) is a prescription treatment for adults with hepatitis C virus (HCV) genotype 1, 2, 3, 4, 5, or 6 who have been previously treated with an NS5A inhibitor, or for those with genotype 1a or 3 who have been previously treated with sofosbuvir without an NS5A inhibitor. Vosevi has been approved to be used in people with HCV who do not have cirrhosis as well as those with compensated cirrhosis.1

What are the ingredients in Vosevi?

Vosevi is a combination medication. Each tablet contains 400 mg of sofosbuvir, 100 mg of velpatasvir, and 100 mg of voxilaprevir.1

How does Vosevi work?

Each of the three active ingredients in Vosevi have a different way of targeting the HCV. Sofosbuvir is a nucleotide analog NS5B polymerase inhibitor, which fights the HCV infection by keeping the virus from multiplying in the liver. Velpatasvir is an NS5A inhibitor. NS5A is a key protein the HCV needs to multiply. Voxilaprevir inhibits NS3/4A protease, an enzyme that is also needed for the virus to multiply.1

What are the possible side effects?

In clinical trials, the most common side effects experienced by patients taking Vosevi were headache, fatigue, diarrhea, and nausea.1

Vosevi may cause serious side effects, including a reactivation of hepatitis B virus, in people who previously had hepatitis B. In some people, a reactivation of the hepatitis B virus can lead to liver failure and death. Prior to starting treatment with Vosevi, patients should have a blood test to check for previous hepatitis B infection.1

Another possible side effect that may occur with Vosevi and that can be serious is a slowed heart rate (bradycardia), which was seen in people who take certain medications for heart problems, like amiodarone (brand names Cordarone®, Nexterone®, Pacerone®). Patients who experience fainting or feeling faint, dizziness, lightheadedness, weakness, extreme tiredness, shortness of breath, chest pains, confusion, or memory problems should seek immediate medical attention.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

Vosevi should not be taken by anyone who is taking the medication rifampin (brand names Rifater®, Rifamate®, Rimactane®, and Rifadin®).1,2

Vosevi should not be used by people with moderate to severe liver impairment or those with severe or end-stage kidney disease.1

Before starting treatment with Vosevi, people with HCV should talk to their doctor about all their medical conditions, especially:1

  • Previous hepatits B infection*
  • Other liver problems
  • Severe kidney disease or treatment with dialysis

It is not known if Vosevi is safe for an unborn baby or if the medication passes into breastmilk. Women who are pregnant, breastfeeding, or plan to become pregnant or breastfeed should talk to their doctor about their treatment options and the risks to their infants.1

People who are taking Vosevi should talk to their doctor or pharmacist about all their medications, including prescription and over-the-counter medicines, vitamin, and any herbal supplements. Some medications or supplements can interact with each other, cause side effects, or may change the effectiveness of treatment.1

*Direct-acting antiviral drugs (DAA's) now carry a “Black Box Warning” which is used by the FDA to draw attention to serious or life threatening risks. When DAAs are given to treat HCV patients with HBV co-infections, the HBV can potentially reactivate, even if the patient’s immune system held the HBV in-check prior to treatment.

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

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Written by: Emily Downward | Last reviewed: March 2021