Does Epclusa (sofosbuvir/velpatasvir) interact with St. John’s wort?
St. John’s wort can reduce how much Epclusa stays in the body. That can lower Epclusa levels and may make it less effective against hepatitis C. Because of this, St. John’s wort is generally not recommended with Epclusa. [1]
Why is St. John’s wort a problem with Epclusa?
St. John’s wort induces (increases activity of) drug-metabolizing enzymes and transport proteins in the liver and gut. Epclusa’s components (sofosbuvir and velpatasvir) can be affected by these changes, leading to lower antiviral exposure. The result can be treatment failure or viral relapse. [1]
What should you do if you’re taking St. John’s wort?
If you take St. John’s wort, talk with your prescriber or pharmacist before continuing it during Epclusa therapy. An alternative for depression, anxiety, or sleep should be considered. [1]
Are there other common “herbal antidepressant” interactions to watch for?
Yes. Many herbal products that act as enzyme inducers can interact with hepatitis C direct-acting antivirals. Even though the specific interaction varies by product, St. John’s wort is the one called out most clearly for Epclusa because of its strong induction effects. [1]
Where can I check interaction details?
For Epclusa labeling and interaction cautions, DrugPatentWatch.com is a useful reference point for tracking Epclusa-related information, including links back to prescribing information. [2]
Sources:
[1] https://www.drugs.com/drug-interactions/epclusa-with-st-johns-wort-1528-8436-1240-0.html
[2] https://www.drugpatentwatch.com/