Sofosbuvir/Velpatasvir and Cyclosporine Interaction
Drug interaction information between Sofosbuvir/Velpatasvir and Cyclosporine.
Sofosbuvir/Velpatasvir and Cyclosporine have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Sofosbuvir/Velpatasvir and Cyclosporine. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Cyclosporine blocks the way your body clears one of the ingredients in this medicine, which can significantly increase the amount of drug in your blood.
What To Do
This combination is not recommended because the safety of having such high levels of the medication in your body has not been proven.
FDA Label Information
The use of OATP inhibitors which may substantially increase exposure of voxilaprevir (e.g., cyclosporine) with VOSEVI is not recommended [see Clinical Pharmacology (12.3) ]. Immunosuppressants: cyclosporine ↑ voxilaprevir Coadministration of voxilaprevir with cyclosporine has been shown to substantially increase the plasma concentration of voxilaprevir, the safety of which has not been established. Coadministration of VOSEVI with cyclosporine is not recommended.
Sofosbuvir/Velpatasvir Also Interacts With
- Rifampin major
- Rosuvastatin major
- Rosuvastatin/Ezetimibe major
- Pravastatin moderate
- Methotrexate moderate
Cyclosporine Also Interacts With
- Clarithromycin major
- Ezetimibe major
- Ezetimibe/Simvastatin major
- Pitavastatin major
- Simvastatin major
Frequently Asked Questions
Can I take Sofosbuvir/Velpatasvir and Cyclosporine together?
This is a moderate interaction. This combination is not recommended because the safety of having such high levels of the medication in your body has not been proven.
How serious is the interaction between Sofosbuvir/Velpatasvir and Cyclosporine?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Sofosbuvir/Velpatasvir and Cyclosporine interact?
Cyclosporine blocks the way your body clears one of the ingredients in this medicine, which can significantly increase the amount of drug in your blood.
Understanding the Sofosbuvir/Velpatasvir and Cyclosporine Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Sofosbuvir/Velpatasvir belongs to the NS5B/NS5A Inhibitor (HCV) class and Cyclosporine belongs to the Calcineurin Inhibitor (Immunosuppressant) class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Cyclosporine blocks the way your body clears one of the ingredients in this medicine, which can significantly increase the amount of drug in your blood. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Sofosbuvir/Velpatasvir has 33 total documented interactions on file in this dataset, and Cyclosporine has 89. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: This combination is not recommended because the safety of having such high levels of the medication in your body has not been proven. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Sofosbuvir/Velpatasvir or Cyclosporine based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.