rifampin vs sofosbuvir/velpatasvir
Side-by-side comparison of rifampin and sofosbuvir/velpatasvir. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
major Known Drug Interaction
Antimycobacterials: rifampin ↓ sofosbuvir ↓ velpatasvir ↑ voxilaprevir (single dose) ↓ voxilaprevir (multiple dose) Coadministration with rifampin is contraindicated [see Contraindications (4) ].
Recommendation: You should not take these two drugs together because the hepatitis C treatment will likely fail.
Rifadin
Epclusa
Rifampin is an antibiotic medicine. It fights bacteria in your body to treat infections.
Vosevi is a drug that combines three medicines into one tablet. It is used to treat hepatitis C in adults who have already tried other treatments.
Rifampin treats tuberculosis (TB) and helps eliminate the bacteria that cause meningitis from your nose and throat. It is important to use rifampin only for infections that are proven or strongly suspected to be caused by bacteria. This helps to prevent bacteria from becoming resistant to the medicine.
Vosevi treats chronic hepatitis C (HCV) infection in adults. It is for those without cirrhosis or with compensated cirrhosis (Child-Pugh A). You can use it if you have genotype 1, 2, 3, 4, 5, or 6 HCV. You must have already been treated with a hepatitis C medicine containing an NS5A inhibitor, or sofosbuvir without an NS5A inhibitor (for genotypes 1a or 3).
Rifampin works by stopping bacteria from growing and multiplying. It does this by blocking a key enzyme that the bacteria need to make proteins. This helps your body fight off the infection.
Vosevi contains sofosbuvir, velpatasvir, and voxilaprevir. Sofosbuvir blocks a protein called NS5B polymerase that the hepatitis C virus needs to multiply. Velpatasvir blocks the NS5A protein, and voxilaprevir blocks the NS3/4A protease protein, both of which the virus also needs.
- • Heartburn
- • Upset stomach
- • Loss of appetite
- • Nausea
- • Vomiting
- • Headache
- • Fatigue (feeling tired)
- • Diarrhea
- • Nausea (feeling sick to your stomach)
- Drug Interaction 970
- Drug Reaction With Eosinophilia And Systemic Symptoms 727
- Nausea 628
- Condition Aggravated 550
- Pyrexia 541
- Feeling tired 2,307
- Hepatitis C infection 1,734
- Headache 1,639
- Feeling sick to your stomach 1,386
- Low red blood cell count 1,185
Rifampin can cause liver problems. Tell your doctor right away if you have yellowing of the skin or eyes, dark urine, or stomach pain. Rifampin can also cause blood problems. Tell your doctor if you have unusual bleeding or bruising.
Vosevi can cause Hepatitis B to become active again if you have had it in the past. This can cause serious liver problems, including liver failure and death. Before starting Vosevi, your doctor will test you for Hepatitis B. They will also monitor you during and after treatment.
Tell your doctor if you are pregnant or plan to become pregnant. Rifampin can make birth control pills less effective, so use other forms of birth control. Talk to your doctor if you are breastfeeding.
It is not known if Vosevi can harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if Vosevi passes into breast milk, so discuss this with your doctor if you are breastfeeding.
How to Read This rifampin vs sofosbuvir/velpatasvir Comparison
rifampin is classified in the Rifamycin Antibiotic drug class, while sofosbuvir/velpatasvir sits within the NS5B/NS5A Inhibitor (HCV) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, rifampin has 3,416 submissions while sofosbuvir/velpatasvir has 8,251. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known major interaction flagged in FDA labeling, attributed to rifampin causes your body to process the hepatitis c medicine too quickly, which lowers the amount of medicine in your blood.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between rifampin and sofosbuvir/velpatasvir - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.