Sofosbuvir/Velpatasvir and Methotrexate Interaction

Drug interaction information between Sofosbuvir/Velpatasvir and Methotrexate.

Sofosbuvir/Velpatasvir and Methotrexate have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Sofosbuvir/Velpatasvir and Methotrexate. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Sofosbuvir/Velpatasvir

NS5B/NS5A Inhibitor (HCV)

Drug B

Methotrexate

Disease-Modifying Antirheumatic Drug (DMARD)

How They Interact

This medication can block a specific protein that helps move methotrexate out of your body, which may lead to higher levels of methotrexate in your system.

FDA Label Information

Coadministration of VOSEVI with BCRP substrates (e.g., methotrexate, mitoxantrone, imatinib, irinotecan, lapatinib, rosuvastatin, sulfasalazine, topotecan) is not recommended [see Clinical Pharmacology (12.3) ].

Methotrexate Also Interacts With

View all Methotrexate interactions →

Frequently Asked Questions

What SPL severity band is on file for Sofosbuvir/Velpatasvir + Methotrexate?

Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Methotrexate has 38 labeled pairs on file vs Sofosbuvir/Velpatasvir's 33. In the moderate band specifically: Sofosbuvir/Velpatasvir has 10 (also Pravastatin, Cyclosporine, Carbamazepine, Amiodarone); Methotrexate has 12 (also Celecoxib, Diflunisal, Indomethacin, Mefenamic Acid).

What mechanism field is on file for Sofosbuvir/Velpatasvir and Methotrexate?

This medication can block a specific protein that helps move methotrexate out of your body, which may lead to higher levels of methotrexate in your system.

Sofosbuvir/Velpatasvir carries more major-labeled pairs than Methotrexate

SPL source-record counts only. This page's band is moderate · classes on file: Sofosbuvir/Velpatasvir (NS5B/NS5A Inhibitor (HCV)); Methotrexate (Disease-Modifying Antirheumatic Drug (DMARD)).

Sofosbuvir/Velpatasvir has 3 major-labeled pairs vs Methotrexate's 0. This page itself is in the moderate band, not the major band.

Sofosbuvir/Velpatasvir

3 major · 10 moderate · 20 minor · 33 total

Methotrexate

0 major · 12 moderate · 26 minor · 38 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.