Sovaldi

Sofosbuvir is very well tolerated with minimal side effects. It is difficult to determine specific side effects of Sovaldi because it has been previously studied with ribavirin and pegylated interferon and documented side effects are likely due to those medications. When Sovaldi is taken with these medications (no longer recommended), the most common side effects reported are fatigue, headaches, nausea, fever, chills, and arthralgia (joint pain). Pegylated interferon has been associated with depression, anxiety, and, in rare cases, suicidal thoughts. If you have a history of any of these conditions, talk to your provider before starting it. Sovaldi is also present in several co-formulated tablets (Harvoni, Epclusa, and Vosevi). For more information on the side effects of these medications, see their respective drug pages.

Pregnant women or women who are trying to become pregnant should avoid use if the addition of ribavirin is required. Women of childbearing age and their male partners must use two forms of birth control throughout treatment and for six months after treatment with ribavirin. Changes in hematological (blood) values are also common, and routine blood testing to look for anemia, neutropenia, and other blood conditions is recommended.

Before starting sofosbuvir, be sure to tell your medical provider or pharmacist about all of the medications, supplements, and herbal products you take, whether they are prescribed, over-the-counter, or illicit. It is also important to inform them of any changes as they happen during treatment. No sofosbuvir-based HCV regimens are to be used with amiodarone due to possible symptomatic bradycardia. Signs of bradycardia (slow heart rate) include fainting, dizziness, lightheadedness, weakness, excessive fatigue, shortness of breath, chest pains, and confusion or memory problems. Consult a medical provider should any of these occur. Sovaldi cannot be taken with the HIV medication tipranavir/ritonavir but is safe to take with other HIV medications. Do not take Sovaldi with St. John’s wort, and in general, herbal products should be avoided due to lack of information regarding potential for interaction. Sovaldi should not be taken with rifamycin antimicrobials, such as rifampin, rifabutin, rifapentine, or certain anticonvulsants, such as phenobarbital, carbamazepine, phenytoin, and oxcarbazepine, as they reduce the concentrations and its effectiveness.

Sovaldi is almost never prescribed. It is contained, however, in the co-formulated medications Epclusa, Harvoni, or Vosevi, which are very commonly used today. Approved in 2013, the original sofosbuvir dosage and duration is already pretty much obsolete when compared to other HCV treatments. Sovaldi is a drug with a lot of “firsts”—first drug of its class, first drug to receive FDA approval for use without interferon, and the first DAA to receive FDA approval for use in HIV/HCV co-infected patients.