Rifabutin and Sofosbuvir and velpatasvir interaction
Rifabutin and Sofosbuvir and velpatasvir: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Sofosbuvir and velpatasvir (Vosevi) label · effective 2025-07-14
Antimycobacterials: rifampin ↓ sofosbuvir ↓ velpatasvir ↑ voxilaprevir (single dose) ↓ voxilaprevir (multiple dose) Coadministration with rifampin is contraindicated [see Contraindications (4) ]. rifabutin rifapentine ↓ sofosbuvir ↓ velpatasvir ↓ voxilaprevir Coadministration is not recommended.
From the Rifabutin label · effective 2026-09-01
ND 36% ↓ in C max and 24% ↓ AUC Co-administration of rifabutin with sofosbuvir (alone or in combination) is not recommended.
…antiretroviral drugs metabolized by CYP3A, including but not limited to products containing bictegravir, elvitegravir, oral rilpivirine, or doravirine and anti-HCV drugs including but not limited to sofosbuvir (alone or in combination) may decrease plasma concentrations of those drugs, which may lead to loss of virologic response and possible development of resistance.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.