Drug interactions
Nirmatrelvir + Sofosbuvir-velpatasvir
Severity: Minor
Nirmatrelvir and Sofosbuvir-velpatasvir: minor 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, given with ritonavir, inhibits CYP3A4 and P-gp, which may raise velpatasvir and sofosbuvir levels. The increase is unlikely to be harmful over a short 5-day course.
What this interaction means in plain words
Nirmatrelvir and Sofosbuvir-velpatasvir have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Nirmatrelvir belongs to Anti Virals; Sofosbuvir-velpatasvir belongs to Anti Virals.
Why it happens
Ritonavir-boosted nirmatrelvir inhibits CYP3A4 and P-gp, reducing clearance of velpatasvir and sofosbuvir.
What to do
No dose change is required. Monitor for general adverse effects during the short course.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Sofosbuvir-velpatasvir
- Rifampin + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Sofosbuvir-velpatasvir + St john's wort Contraindicated
- Amiodarone + Sofosbuvir-velpatasvir Major
- Apalutamide + Sofosbuvir-velpatasvir Major
- Carbamazepine + Sofosbuvir-velpatasvir Major
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?
MediHelp rates the interaction as minor. Nirmatrelvir and Sofosbuvir-velpatasvir have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Nirmatrelvir, given with ritonavir, inhibits CYP3A4 and P-gp, which may raise velpatasvir and sofosbuvir levels. The increase is unlikely to be harmful over a short 5-day course.
How serious is the interaction between Nirmatrelvir and Sofosbuvir-velpatasvir?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No dose change is required. Monitor for general adverse effects during the short course.
What other medicines interact with Sofosbuvir-velpatasvir?
MediHelp also lists interactions of Sofosbuvir-velpatasvir with, for example, Rifampin, Rifapentine, St john's wort. The full list is on the Sofosbuvir-velpatasvir page.
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