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1 May 2026Oral drugsSource update: September 2023

Sofosbuvir/Velpatasvir = SOF/VEL oral

Sofosbuvir and velpatasvir guidance for chronic hepatitis C across genotypes with or without cirrhosis.

Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.

Therapeutic action

Combination of two direct-acting antivirals: a NS5B polymerase inhibitor (sofosbuvir) and a NS5A inhibitor (velpatasvir).

Indications

Treatment of chronic hepatitis C.

Forms and strengths

  • 400 mg sofosbuvir/100 mg velpatasvir co-formulated tablet.

Dose and duration

Genotypes 1, 2, 3, 4, 5, 6 with no cirrhosis or compensated cirrhosis

  • Adult: one 400 mg/100 mg tablet once daily for 12 weeks.

Genotypes 1, 2, 3, 4, 5, 6 with decompensated cirrhosis

  • Adult: one 400 mg/100 mg tablet once daily for 24 weeks.

Contra-indications, adverse effects, precautions

  • Do not administer to patients with allergy to sofosbuvir or velpatasvir.
  • May cause fatigue, headache, insomnia, nausea, and rash.
  • Administer with caution to patients co-infected with hepatitis B virus because of the risk of HBV reactivation.
  • Do not combine with carbamazepine, phenobarbital, phenytoin, rifampicin, rifabutin, rifapentine, efavirenz, nevirapine, etravirine, or amiodarone.
  • Administer with caution and monitor combination with tenofovir, atorvastatin, and digoxin.
  • Do not administer simultaneously with omeprazole, antacids, or calcium carbonate. Separate dosing as directed.
  • Closely monitor blood glucose levels in patients with diabetes and adjust antidiabetic treatment if necessary.
  • Pregnancy and breast-feeding: contraindicated because safety is not established.
  • Tablets have a bitter taste and should be swallowed whole with meals.

Source

MSF Essential drugs practical guidelines (January 2026)

This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.

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