Drug interactions
Nirmatrelvir + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Moderate
Nirmatrelvir and Sofosbuvir-velpatasvir-voxilaprevir: moderate interaction.
Last updated
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
Nirmatrelvir is a CYP3A4 substrate and inhibitor, and when given as Paxlovid with ritonavir it increases CYP3A and P-gp substrate exposure. Voxilaprevir and velpatasvir levels may rise, with a modest increase in adverse effects.
What this interaction means in plain words
Nirmatrelvir and Sofosbuvir-velpatasvir-voxilaprevir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Nirmatrelvir belongs to Anti Virals; Sofosbuvir-velpatasvir-voxilaprevir belongs to Anti Virals.
Why it happens
Nirmatrelvir with ritonavir inhibits CYP3A4 and P-gp, reducing clearance of voxilaprevir and velpatasvir.
What to do
Monitor for adverse effects of the antiviral regimen during the short 5-day course.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sofosbuvir-velpatasvir-voxilaprevir
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenobarbital + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Phenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifampin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Other interactions of Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Nirmatrelvir with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as moderate. Nirmatrelvir and Sofosbuvir-velpatasvir-voxilaprevir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nirmatrelvir is a CYP3A4 substrate and inhibitor, and when given as Paxlovid with ritonavir it increases CYP3A and P-gp substrate exposure. Voxilaprevir and velpatasvir levels may rise, with a modest increase in adverse effects.
How serious is the interaction between Nirmatrelvir and Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for adverse effects of the antiviral regimen during the short 5-day course.
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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