Sofosbuvir/Velpatasvir/Voxilaprevir + Voriconazole = Precautionary

Effect on Concentration

Sofosbuvir/Velpatasvir/Voxilaprevir
Increase
Applies within class?
No
Voriconazole
No change
Applies within class?
No

Pharmacologic Effects

Sofosbuvir/Velpatasvir/Voxilaprevir
Effect
N/A
Applies within class?
No
Voriconazole
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 20-Jul-2018

Summary

Sources

Sofosbuvir/Velpatasvir/Voxilaprevir versus Voriconazole ^

Study Design

The Phase 1 program evaluated DDIs between sofosbuvir/velpatasvir/voxilaprevir (S/V/V) and drug transporter and CYP probes, immunosuppressants, HIV antiretrovirals (ARV), and oral contraceptives (OC). S/V/V 400/100/ 100 mg ± VOX 100 mg was administered to healthy volunteers to achieve systemic VOX exposures observed across the HCV-infected patient population, as appropriate.

Study Results

VOX AUC was ↑84% when administered with voriconazole; use of CYP3A inhibitors was permitted in Phase 3 trials. There was no effect on Cmax of voxilaprevir when combined.

Study Conclusions

The authors concluded that sofosbuvir/velpatasvir/voxilaprevir should be used with voriconazole only if risks are outweighed by benefits. Careful monitoring for safety and efficacy are warranted.

References

Garrison KL, Kirby B, Stamm LM, Ma G, Vu A. Drug-drug interaction profile of sofosbuvir/velpatasvir/voxilaprevir fixed-dose combination. Ilc: International Liver Conference. Amsterdam, Netherlands. 2017; April 2017.