Sofosbuvir

Aka: Sofosbuvir, Sovaldi

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II. Precautions

  1. See Hepatitis C Antiviral Regimen

III. Indications

  1. See Hepatitis C Antiviral Regimen
  2. Combined with various other agents used in every Hepatitis C virus Genotype
    1. Sofosbuvir is not typically used as HCV monotherapy
    2. Sofosbuvir Ledipasvir (Harvoni)
    3. Sofosbuvir Velpatasvir (Epclusa)
    4. Sofosbuvir Velpatasvir Voxilaprevir (Vosevi)
    5. Sofosbuvir with Ribavirin
      1. Older regimens that have been replaced by other combinations

IV. Contraindications

  1. See Hepatitis C Antiviral Regimen

V. Mechanism

  1. Sofosbuvir is a NS5B Polymerase Inhibitor (...buvirs)
    1. Blocks RNA Polymerase, resulting in inhibition of viral replication

VI. Evaluation

  1. See Hepatitis C Antiviral Regimen for Pre and post-treatment protocols

VII. Adverse Effects

  1. See Hepatitis C Antiviral Regimen
  2. Headache
  3. Anemia
  4. Fatigue
  5. Nausea

VIII. Drug Interactions

  1. See Hepatitis C Antiviral Regimen
  2. Fewest Drug Interactions of the anti-HCV agents
  3. Reacts with potent P-Glycoprotein Inducers that lower Sofosbuvir drug levels (and its efficacy)
    1. Carbamazepine
    2. Rifampin
    3. Oxcarbazepine
    4. Phenobarbital
    5. Phenytoin
    6. Rifabutin
    7. Rifampin
    8. Rifapentine
    9. St. Johns Wort
    10. Tipranavir/r
  4. Amiodarone
    1. Causes severe Bradycardia resulting in Cardiac Arrest and pacer placement
  5. Safe Drugs
    1. No significant CYP450 interactions
    2. Does not interact with Statins

IX. Monitoring

  1. See Hepatitis C Antiviral Regimen

X. Resources

  1. Sovaldi (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=80beab2c-396e-4a37-a4dc-40fdb62859cf

XI. References

  1. (2023) Presc Lett, Hepatitis C Treatment Overview, Resource #390902
  2. (2014) Presc Lett 21(2): 8-9

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Related Studies

Cost: Medications

sofosbuvir (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SOFOSBUVIR-VELPATASVIR 400-100 Generic $278.71 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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