Drug interactions
Nirmatrelvir / ritonavir + Sofosbuvir-velpatasvir-voxilaprevir
Severity: Moderate
Nirmatrelvir / ritonavir 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
Ritonavir strongly inhibits CYP3A4, P-gp and OATP, which may raise velpatasvir and voxilaprevir exposure. Because the course of nirmatrelvir/ritonavir is short, the effect is typically limited.
What this interaction means in plain words
Nirmatrelvir / ritonavir 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.
Why it happens
Ritonavir inhibits CYP3A4, P-gp and OATP, reducing clearance of velpatasvir and voxilaprevir.
What to do
Monitor for adverse effects of the hepatitis C regimen during and shortly after the 5-day course. No empirical dose change is needed.
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
Frequently asked questions
Can I take Nirmatrelvir / ritonavir with Sofosbuvir-velpatasvir-voxilaprevir?
MediHelp rates the interaction as moderate. Nirmatrelvir / ritonavir 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. Ritonavir strongly inhibits CYP3A4, P-gp and OATP, which may raise velpatasvir and voxilaprevir exposure. Because the course of nirmatrelvir/ritonavir is short, the effect is typically limited.
How serious is the interaction between Nirmatrelvir / ritonavir 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 hepatitis C regimen during and shortly after the 5-day course. No empirical dose change is needed.
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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