Spotlight Series on Hepatitis C


Sofosbuvir + Velpatasvir (Epclusa) -- Interactions With Other Medicines

July 2016

The fixed-dose combination of sofosbuvir + velpatasvir (sold as Epclusa) has activity against all major strains, or genotypes, of hepatitis C virus (HCV). The combination of these drugs has been evaluated for possible and potential interactions with other drugs.


Here are recommendations from Epclusa manufacturer Gilead Sciences:

In people coinfected with HIV and HCV, the following drugs can be used:

Nukes (Nucleoside and Nucleotide Analogues)

  • FTC (emtricitabine)
  • TAF (tenofovir alafenamide)
  • TDF (tenofovir DF; the original formulation of tenofovir)



  • rilpivirine (Intelence and in Complera)

Integrase Inhibitors

  • dolutegravir (Tivicay and in Triumeq)
  • elvitegravir (in Genvoya and Stribild)
  • raltegravir (Isentress)

Protease Inhibitors

  • atazanavir (Reyataz)
  • darunavir (Prezista and in Prezcobix)
  • lopinavir (in Kaletra)


  • ritonavir (Norvir and in Kaletra)
  • cobicistat (in Genvoya and Stribild)

What is clear from the drug interaction studies with Epclusa is that the anti-HIV drug efavirenz (Sustiva, Stocrin and in Atripla) must not be used because it can reduce absorption of velpatasvir by about 50%.

Hormonal Contraceptives ("The Pill")

No loss of efficacy with oral contraceptives containing norgestimate/thinly estradiol should occur.

Transplant Drugs

Sofosbuvir-velpatasvir does not appear to have significant interactions with cyclosporine (Neoral, Sandimmune) or tacrolimus (Advagraf, Prograf).

Complete details about drug interactions between sofosbuvir-velpatasvir and other medicines will be released in the future by Gilead.


Mogalian E, McNally J, Shen G, et al. Drug-drug interaction profile of sofosbuvir-velpatasvir fixed-dose combination. The International Liver Congress, 13-17 April 2017, Barcelona, Spain. Abstract FRI-168.

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Sofosbuvir + Velpatasvir (Epclusa) in HIV Coinfection
Sofosbuvir + Velpatasvir (Epclusa) -- Improvements in Quality of Life, Energy and Emotional and Mental Health

This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication TreatmentUpdate. Visit CATIE's Web site to find out more about their activities, publications and services.

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