Vosevi

Vosevi is a prescription antiviral medication used to treat chronic hepatitis C virus (HCV) infection in adults. It is a fixed-dose combination of three direct-acting antivirals: sofosbuvir, velpatasvir, and voxilaprevir. Sofosbuvir inhibits the NS5B RNA polymerase, velpatasvir inhibits the NS5A replication factor, and voxilaprevir inhibits the NS3/4A protease, collectively blocking multiple steps of HCV replication.

Vosevi is indicated for adults with chronic HCV infection who have previously failed treatment with a regimen that included an NS5A inhibitor or who relapsed after prior therapy. It is active across major HCV genotypes (1-6) in this treatment-experienced population. It is not generally used as a first-line option for treatment-naïve patients.

The medication is taken orally once daily with food. The usual duration is 8 to 12 weeks, depending on the patient’s genotype and prior treatment history. The fixed-dose tablet contains velpatasvir 100 mg, sofosbuvir 400 mg, and voxilaprevir 100 mg.

Common adverse effects include fatigue, diarrhea, nausea, and headache. Serious risks can include liver injury and reactivation of hepatitis B in co-infected patients if treatment is interrupted. Vosevi can interact with drugs that affect the enzymes and transporters used to metabolize it, such as strong CYP3A and P-glycoprotein inducers or inhibitors, and with amiodarone, where there is a risk of severe bradycardia. It is not recommended in patients with severe renal impairment or certain hepatic conditions, and caution is advised in those with coexisting medical conditions or concurrent therapies.