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Vosevi

Vosevi is a combination antiviral medication containing sofosbuvir, velpatasvir, and voxilaprevir. It is used to treat chronic hepatitis C virus (HCV) infection in adults. Vosevi is typically prescribed for patients who have previously failed treatment with other HCV medications. This combination works by targeting different stages of the viral life cycle, helping to eliminate the virus from the bloodstream and prevent further liver damage.

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Frequently Asked Questions

How long does it take for Vosevi to cure hepatitis C?
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Vosevi is typically taken for 12 weeks, but the exact duration depends on the patient’s previous treatment history and viral genotype. It can achieve a sustained virologic response (SVR), meaning the virus is no longer detectable in the bloodstream after treatment.

Can I take Vosevi with other medications?
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You should inform your healthcare provider about all medications, including over-the-counter drugs and supplements, as some can interact with Vosevi and reduce its effectiveness. Certain medications like rifampin and amiodarone should not be taken with Vosevi.

Can Vosevi cause liver problems?
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Vosevi can cause or worsen liver issues in some patients, particularly those with pre-existing liver conditions. Regular liver function monitoring is required during treatment.

What should I do if I miss a dose of Vosevi?
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If you miss a dose of Vosevi, take it as soon as you remember, but if it is close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double up doses.

Is Vosevi a cure for hepatitis C?
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Yes, Vosevi is considered a cure for hepatitis C in many cases, as it can lead to sustained virologic response (SVR), meaning the virus is no longer detectable after completing the treatment course.

Comprehensive Drug Guide

How Does Vosevi Work?

Vosevi works by combining three antiviral agents, each targeting a different aspect of the hepatitis C virus's life cycle. Sofosbuvir inhibits the NS5B RNA polymerase, blocking viral replication. Velpatasvir blocks the NS5A protein, preventing the virus from assembling and multiplying. Voxilaprevir inhibits the NS3/4A protease, which the virus uses to process proteins necessary for its survival. This combination effectively prevents the virus from multiplying and helps the immune system clear the infection.

Common Dosages

  • Sofosbuvir 400 mg
  • Velpatasvir 100 mg
  • Voxilaprevir 100 mg

The recommended dose is one tablet taken orally once daily with food.

Typical Dosing

  • Adults: The usual dose is one tablet once daily, taken with food, for 12 weeks. The duration of treatment may vary based on the patient’s previous treatment experience and viral genotype.

Typical Dosing

FDA Approved Indications

  • Chronic hepatitis C virus (HCV) infection in adults with genotype 1-6, who have failed prior treatment with an NS5A inhibitor or other direct-acting antiviral treatments.

Who Shouldn't Take Vosevi?

  • Severe kidney impairment or end-stage renal disease (without proper medical supervision).
  • Known hypersensitivity to sofosbuvir, velpatasvir, voxilaprevir, or any components of the formulation.
  • Concomitant use of rifampin, a potent CYP3A inducer, as it can reduce the effectiveness of Vosevi.

Advice From The Pharmacist

  • Take Vosevi with food to help with absorption and to reduce the likelihood of stomach upset.
  • Do not skip doses. It is important to take Vosevi at the same time each day to maintain consistent drug levels in the body.
  • Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as some may interact with Vosevi and affect its efficacy.
  • Keep regular appointments for blood tests to monitor liver function and ensure the treatment is working as expected.

Side Effects of Vosevi

Common Side Effects

  • Headache
  • Fatigue
  • Nausea
  • Diarrhea

Uncommon/Severe Side Effects

  • Liver problems, especially in patients with existing liver disease
  • Reactivation of hepatitis B in patients co-infected with HCV and hepatitis B

Risks and Warnings of Vosevi

  • Hepatitis B Reactivation: Patients with a history of hepatitis B infection should be monitored closely during and after Vosevi treatment, as the medication can cause reactivation of the virus.
  • Liver Health: Vosevi may worsen liver function in patients with advanced liver disease. Regular liver function tests are essential during treatment.
  • Drug Interactions: Vosevi can interact with certain medications, including antacids and proton pump inhibitors. These should be taken at a different time of day, as they may reduce Vosevi's absorption.

Interactions with Vosevi

Common Drug Interactions

  • Rifampin: Reduces the effectiveness of Vosevi and should not be used concurrently.
  • Amiodarone: Combining Vosevi with amiodarone may cause dangerous slowing of the heart rate (bradycardia).
  • Proton Pump Inhibitors: These medications can decrease Vosevi's effectiveness. If you must take a PPI, it should be taken with food at the same time as Vosevi.

Alternatives to Vosevi

  • Harvoni (ledipasvir/sofosbuvir): Another combination antiviral used for the treatment of chronic hepatitis C infection.
  • Epclusa (sofosbuvir/velpatasvir): A two-drug combination similar to Vosevi, often used as first-line treatment for HCV.
  • Mavyret (glecaprevir/pibrentasvir): A combination DAA used for the treatment of all genotypes of hepatitis C infection.