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Pan-genotypic DAA salvage combination

Sofosbuvir with velpatasvir and voxilaprevir

Brand names: Vosevi

Adult dose

Dose: 400/100/100mg PO OD for 12 weeks
Route: PO
Frequency: OD

Clinical pearls

  • Salvage therapy for HCV with prior DAA failure
  • Screen HBV before

Contraindications

  • Decompensated cirrhosis (Child-Pugh B/C)
  • Concurrent rifampicin/strong inducers
  • Concurrent ethinylestradiol (hepatotoxicity)
  • Hypersensitivity

Side effects

  • Headache
  • Fatigue
  • Diarrhoea
  • HBV reactivation
  • Hepatotoxicity

Interactions

  • Many — see Liverpool HEP
  • PPIs
  • Statins

Monitoring

  • LFTs
  • HCV RNA
  • HBV DNA

Reference: BNF; NICE TA507; EASL; https://bnf.nice.org.uk/drugs/sofosbuvir-with-velpatasvir-and-voxilaprevir/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.