Vosevi

— THERAPEUTIC CATEGORIES —
  • Viral infections

Vosevi Generic Name & Formulations

General Description

Sofosbuvir, velpatasvir, voxilaprevir 400mg/100mg/100mg; tabs.

Pharmacological Class

HCV NS5B polymerase inhibitor + HCV NS5A inhibitor + HCV NS3/4A protease inhibitor.

How Supplied

Tabs—28

Manufacturer

Generic Availability

NO

Vosevi Indications

Indications

Chronic hepatitis C virus (HCV) infection in adults without cirrhosis or with compensated cirrhosis (Child-Pugh A) who have genotype 1, 2, 3, 4, 5, or 6 and were previously treated with an NS5A inhibitor-containing regimen or have genotype 1a or 3 and were previously treated with a sofosbuvir-containing regimen without an NS5A inhibitor.

Vosevi Dosage and Administration

Adult

Test for HBV infection prior to initiation. Take with food. 1 tab once daily for 12 weeks.

Children

Not established.

Vosevi Contraindications

Contraindications

Concomitant rifampin.

Vosevi Boxed Warnings

Not Applicable

Vosevi Warnings/Precautions

Warnings/Precautions

Risk of HBV reactivation in patients coinfected with HCV/HBV. Test all patients for HBV infection by measuring HBsAg and anti-HBc; if positive serologic evidence, monitor for hepatitis flare or HBV reactivation during and at post-treatment follow-up; treat if clinically indicated. Increased risk of symptomatic bradycardia when concomitant amiodarone esp. patients also taking beta-blockers or with cardiac comorbidities and/or advanced liver disease. Discontinue if evidence of hepatic decompensation/failure develops. Moderate or severe hepatic impairment, history of prior hepatic decompensation: not recommended. Pregnancy. Nursing mothers.

Vosevi Pharmacokinetics

See Literature

Vosevi Interactions

Interactions

Concomitant amiodarone: not recommended; if no alternatives, monitor cardiac function (see full labeling). Concomitant certain immunosuppressants or chemotherapeutic agents: may increase risk of HBV reactivation. May potentiate P-gp, BCRP, OATP1B1, OATP1B3, or OATP2B1 substrates. Concomitant BCRP substrates (eg, methotrexate, mitoxantrone, imatinib, irinotecan, lapatinib, rosuvastatin, sulfasalazine, topotecan): not recommended. Concomitant P-gp and/or moderate to potent CYP2B6, CYP2C8, CYP3A4 inducers (eg, St. John’s wort, carbamazepine), anticonvulsants (eg, phenytoin, phenobarbital, oxcarbazepine), rifabutin, rifapentine, tipranavir/ritonavir, atazanavir-, lopinavir-, or efavirenz-containing regimens, OATP inhibitors (eg, cyclosporine): not recommended. Separate dosing of antacids by 4hrs. May give H2-antagonists simultaneously or staggered from Vosevi (at a dose that does not exceed doses comparable with famotidine 40mg twice daily). May coadminister with omeprazole 20mg. May potentiate digoxin, dabigatran etexilate; monitor. Concomitant tenofovir DF regimens; monitor. May potentiate pravastatin (do not exceed 40mg dose), pitavastatin (not recommended), atorvastatin, fluvastatin, lovastatin, simvastatin; use lowest approved dose. Monitor INR with warfarin.

Vosevi Adverse Reactions

Adverse Reactions

Headache, fatigue, diarrhea, nausea, asthenia, insomnia, rash, depression, lab abnormalities.

Vosevi Clinical Trials

See Literature

Vosevi Note

Not Applicable

Vosevi Patient Counseling

See Literature

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