sofosbuvirvelpatasvirvoxilaprevir

Sofosbuvirvelpatasvirvoxilaprevir is a fixed-dose oral antiviral combination used to treat chronic hepatitis C virus (HCV) infection. It combines three direct-acting antivirals: sofosbuvir, velpatasvir, and voxilaprevir. Marketed under the brand name Vosevi, it is intended primarily as a salvage therapy for patients who have previously failed other direct-acting antiviral (DAA) regimens.

Mechanism of action for the three components targets multiple steps of the HCV replication cycle. Sofosbuvir is a nucleotide NS5B polymerase inhibitor, velpatasvir inhibits the NS5A protein, and voxilaprevir inhibits the NS3/4A protease. By combining these activities, the regimen aims to suppress viral replication across diverse HCV genotypes and to overcome resistance observed after prior DAA exposure.

Indications and use are for adults with chronic HCV infection who have previously failed a regimen containing an NS5A inhibitor or a protease inhibitor, or who have not responded to prior DAA therapy. Treatment duration is generally in the range of 8 to 12 weeks and is tailored to prior treatment history, genotype, and the presence of cirrhosis or other liver conditions. The medication is taken orally once daily, typically with food, as a single fixed-dose tablet.

Safety and adverse effects include common experiences such as fatigue, headache, and nausea, with potential liver-related risks in patients with advanced liver disease. It can interact with other drugs metabolized by CYP3A and with strong inducers or inhibitors of hepatic enzymes, requiring careful review of concomitant medications. Resistance considerations emphasize its role as salvage therapy, reducing the likelihood of retreatment failure by combining multiple antiviral targets.

History notes that sofosbuvir/velpatasvir/voxilaprevir received regulatory approval in the late 2010s as a targeted option for treatment-experienced HCV patients, complementing first-line DAA regimens.