Sofosbuvir + velpatasvir – interactions with other medicines
The fixed-dose combination of sofosbuvir + velpatasvir (sold as Epclusa) has activity against all major strains, or genotypes, of hepatitis C virus (HCV). The combination of these drugs has been evaluated for possible and potential interactions with other drugs.
Here are recommendations from Epclusa manufacturer Gilead Sciences:
In people co-infected with HIV and HCV, the following drugs can be used:
Nukes (nucleoside and nucleotide analogues)
- FTC (emtricitabine)
- TAF (tenofovir alafenamide)
- TDF (tenofovir DF; the original formulation of tenofovir)
- rilpivirine (Intelence and in Complera)
- dolutegravir (Tivicay and in Triumeq)
- elvitegravir (in Genvoya and Stribild)
- raltegravir (Isentress)
- atazanavir (Reyataz)
- darunavir (Prezista and in Prezcobix)
- lopinavir (in Kaletra)
- ritonavir (Norvir and in Kaletra)
- cobicistat (in Genvoya and Stribild)
What is clear from the drug interaction studies with Epclusa is that the anti-HIV drug efavirenz (Sustiva, Stocrin and in Atripla) must not be used because it can reduce absorption of velpatasvir by about 50%.
Hormonal contraceptives (“the pill”)
No loss of efficacy with oral contraceptives containing norgestimate/thinly estradiol should occur.
Sofosbuvir-velpatasvir does not appear to have significant interactions with cyclosporine (Neoral, Sandimmune) or tacrolimus (Advagraf, Prograf).
Complete details about drug interactions between sofosbuvir-velpatasvir and other medicines will be released in the future by Gilead.
—Sean R. Hosein
Mogalian E, McNally J, Shen G, et al. Drug-drug interaction profile of sofosbuvir-velpatasvir fixed-dose combination. The International Liver Congress, 13-17 April 2017, Barcelona, Spain. Abstract FRI-168.