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
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What are the side effects of Vosevi?
Common Side Effects
- Headache (21-23%)
- Low energy (17-19%)
- Diarrhea (13-14%)
- Nausea (10-13%)
- Weakness (4-6%)
- Trouble sleeping (3-6%)
Other Side Effects
- Rash
- Depressed mood
Serious Side Effects
Source: DailyMed
The following 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):
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.
Frequently asked questions about Vosevi
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What are the 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 forms
Typical dosing 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?
Vosevi contraindications
Taking rifampin (Rifadin) at the same time
What are alternatives to Vosevi?
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
Hepatitis C infection genotype 1, 4, 5, and 6
Chronic hepatitis C infection
Vosevi images
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