Vosevi
Vosevi is a combination of three antiviral medications: sofosbuvir, velpatasvir, and voxilaprevir. It's one of the first-choice treatments for people who've been treated but not cured of hepatitis C, an infection caused by the hepatitis C virus (HCV) in the liver. This medication is only taken once a day, but can sometimes cause headaches.
What is Vosevi?
What is Vosevi used for?
- Adults with hepatitis C infection genotype 1, 2, 3, 4, 5, or 6 and previously treated with an NS5A inhibitor
- Adults with hepatitis C infection genotype 1a or 3 and previously treated with sofosbuvir without an NS5A inhibitor
How Vosevi works
Vosevi contains three antiviral medications that work together to treat hepatitis C.
- Sofosbuvir is a nucleotide polymerase inhibitor. It prevents the hepatitis C virus (HCV) from making copies of itself, which lowers the amount of viruses in your body.
- Velpatasvir is an HCV NS5A inhibitor. By blocking the HCV NS5A protein, it stops the HCV from making new viruses.
- Voxilaprevir is a protease inhibitor, and prevents the HCV from cutting certain proteins it needs to make new viruses.
Drug facts
Side effects of Vosevi
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (21-23%)
- Low energy (17-19%)
- Diarrhea (13-14%)
- Nausea (10-13%)
- Weakness (4-6%)
- Trouble sleeping (3-6%)
Less Common Side Effects
- Rash
- Depressed mood
Vosevi serious side effects
Contact your healthcare provider immediately if you experience any of the following.
Liver failure caused by hepatitis B virus reactivation: nausea, stomach pain, yellowing of your skin or whites of your eyes
The following Vosevi side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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Pros and cons of Vosevi
Pros
- Only taken once daily
- 96% of people in a clinical study were cured of HCV
- Combines three medications in a single pill for convenience
- Can be used in people with kidney problems
Cons
- Must be taken with food
- Brand name only, so might be expensive
- Unknown if safe or works well in children
- Not recommended in people with moderate to severe liver problems
Pharmacist tips for Vosevi
- Take Vosevi at the same time every day with food. This is because taking it on an empty stomach will cause less medication to get absorbed into your body.
- It's important to never miss or skip doses of Vosevi so it can properly treat your infection. Set an alarm to help you remember to take it every day.
- Make sure to tell your provider all of the medications you're taking and if you start any new medications so they can make sure there aren't any interactions with Vosevi.
- If you need to take an antacid that contains aluminum or magnesium, take it either 4 hours before or 4 hours after you take Vosevi. If you take them too close together, a lower amount of Vosevi might be absorbed into your body. This will make it work less well to treat your HCV infection.
- It's important to continue taking Vosevi for the entire time your provider has told you to take it, even if you're feeling better. If you stop taking it early, you can raise the risk of your infection coming back and being harder to treat.
- If you're pregnant or breastfeeding, discuss the risks and benefits of Vosevi for you and your unborn baby with your provider. It isn't known if this medication passes into human breast milk, but it has been present in animal breast milk and no harm has been seen in their breastfed babies.
- If you take too much Vosevi, call your provider or go to the nearest emergency room.
Common questions about Vosevi
Your provider will determine how long you should take Vosevi to treat your hepatitis C infection. Typically, it's taken daily for about 3 months.
Both Vosevi and Epclusa are used to treat hepatitis C infection genotype 1, 2, 3, 4, 5, or 6. But Vosevi is only meant for people who've previously been treated with certain HCV medications, but are not cured. Vosevi contains three different antiviral medications (sofosbuvir, velpatasvir, and voxilaprevir) and Epclusa only contains two (sofosbuvir and velpatasvir). While Vosevi can only be used in adults, Epclusa can be used in adults and children 3 years and older. There is currently a generic version of Epclusa available, but Vosevi is only available as a brand name medication.
Most people who take Vosevi are cured from their hepatitis C infection after about 3 months of treatment. In studies, 96% of people treated with this medication were cured. "Cure" means the hepatitis C virus isn't seen in your blood 3 months after you finish your treatment. Once you've been cured, it's still possible to be infected with the virus again. While most people get cured from their hepatitis C infection after taking this medication, some don't and might need a different treatment. Be sure to let your provider know if you experience nausea, tiredness, yellowing of your skin or whites of your eyes, or stomach pain, since these can be signs of liver damage which could be due to your infection getting worse.
There isn't enough information available to know if Vosevi is safe to take during pregnancy. In animal studies, it didn't cause harm to pregnant mothers or their unborn babies. Speak to your provider about the risks and benefits of taking Vosevi during pregnancy.
It isn't recommended to take Vosevi if you have moderate to severe liver problems, since this can cause the medication to build up in your body and lead to more side effects. There have been cases of liver failure in people with more severe liver problems who took Vosevi. If you have mild liver problems, speak to your provider to make sure Vosevi is safe for you to take.
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Risks and warnings for Vosevi
Vosevi can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Hepatitis B reactivation
- Risk factors: History of hepatitis B infection | Taking medications that lower your immune system
Some people who have both hepatitis B and C infections have had their hepatitis B reactivate or flare up after starting treatment for hepatitis C. This can cause serious liver problems, and sometimes death, if not caught and treated in time. You should be tested for hepatitis B before you start Vosevi. Tell your provider if you've ever had hepatitis B or have been treated for it in the past.
Liver problems
- Risk factors: History of liver problems
Vosevi might worsen liver problems and lead to liver failure or death in people with a history of liver problems (e.g., cirrhosis). It's not recommended to take it if you have moderate to severe liver problems. Tell your provider if you have a history of liver problems before starting Vosevi. You might need to get labs done so your provider can check the health of your liver. Watch out for signs of liver damage, including yellowing of your skin or whites of your eyes, nausea, and stomach pain. Contact your provider if you notice any of these symptoms.
Slow heart rate
- Risk factors: Taking amiodarone (Pacerone) | Taking beta blockers | Heart problems | Liver problems
There have been cases of slow heartbeat and serious heart problems in people taking amiodarone (Pacerone) and medications containing sofosbuvir, including Vosevi, together. It usually happens within hours to days of starting Vosevi, but it can also happen weeks after starting it. It's more likely to happen in people also taking beta blockers or people with heart or liver problems. Tell your provider if you're taking or have recently taken amiodarone (Pacerone). They might choose a different hepatitis C medication for you or closely monitor your heartbeat. Go to the emergency room right away if you take these medications together and feel faint, dizzy, weak, confused, or have chest pain or trouble breathing.
Medications that make Vosevi not work as well
Certain medications might lower the amount of Vosevi in your body and cause it to work less well to treat your hepatitis C infection. Examples include medications like St. John's wort and carbamazepine (Tegretol). Tell your provider or pharmacist all of the medications you're taking and if you start any new medications while taking Vosevi so they can determine if it's safe to take together or adjust your doses if needed.
Vosevi dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 400mg/100mg/100mg | 28 tablets | $23,929.45 | $854.62 |
Typical dosage for Vosevi
Each tablet of Vosevi contains 400 mg of sofosbuvir, 100 mg of velpatasvir, and 100 mg of voxilaprevir.
The typical dose is 1 tablet of Vosevi by mouth once daily with food for about 3 months.
How much does Vosevi cost?
$23,929.45
Vosevi contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Vosevi will not be safe for you to take.
- Taking rifampin (Rifadin) at the same time
What are alternatives to Vosevi?
Vosevi images
