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Drug interactions

Atazanavir + Sofosbuvir-velpatasvir-voxilaprevir

Severity: Major

Atazanavir and Sofosbuvir-velpatasvir-voxilaprevir: major interaction.

Last updated Sources: US FDA label

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Atazanavir raises voxilaprevir exposure, likely through OATP1B and CYP3A inhibition. Higher voxilaprevir levels may increase adverse effects such as liver enzyme elevations. Labeling does not recommend the combination.

What this interaction means in plain words

Atazanavir and Sofosbuvir-velpatasvir-voxilaprevir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Atazanavir belongs to Anti Virals; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.

Evidence level: Moderate

Why it happens

Atazanavir inhibits OATP1B1/1B3 and CYP3A4, which increases voxilaprevir concentrations.

What to do

Avoid the combination and consider a different HCV regimen or antiretroviral. If it is unavoidable, monitor liver tests.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Atazanavir with Sofosbuvir-velpatasvir-voxilaprevir?

MediHelp rates the interaction as major. Atazanavir and Sofosbuvir-velpatasvir-voxilaprevir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir raises voxilaprevir exposure, likely through OATP1B and CYP3A inhibition. Higher voxilaprevir levels may increase adverse effects such as liver enzyme elevations. Labeling does not recommend the combination.

How serious is the interaction between Atazanavir and Sofosbuvir-velpatasvir-voxilaprevir?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and consider a different HCV regimen or antiretroviral. If it is unavoidable, monitor liver tests.

What other medicines interact with Sofosbuvir-velpatasvir-voxilaprevir?

MediHelp also lists interactions of Sofosbuvir-velpatasvir-voxilaprevir with, for example, Fosphenytoin, Phenobarbital, Phenytoin. The full list is on the Sofosbuvir-velpatasvir-voxilaprevir page.

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