Drug & supplement interaction

Adrafinil + Sofosbuvir, Velpatasvir

Sofosbuvir, Velpatasvir brand name: Epclusa.

Moderate Interaction
The bottom line Moderate

Sofosbuvir, Velpatasvir falls into 2 drug categories that Adrafinil can interact with; the most serious is rated moderate. Theoretically, adrafanil might reduce levels and clinical effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Adrafinil and Sofosbuvir, Velpatasvir

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Adrafinil interacts with whole categories of medication. Sofosbuvir, Velpatasvir falls into 2 of those categories, so it can interact with Adrafinil in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

1 of 2

Why this applies to Sofosbuvir, Velpatasvir

Sofosbuvir, Velpatasvir falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Adrafinil interacts with.

Theoretically, adrafanil might reduce levels and clinical effects of CYP3A4 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP3A4 activity.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your hepatitis C combo, Epclusa (sofosbuvir and velpatasvir). Adrafinil turns into modafinil in your body, and modafinil can mildly speed up a liver enzyme called CYP3A4. Velpatasvir is partly handled by that enzyme, so in theory revving it up could lower velpatasvir levels a bit. With a hepatitis C cure, you really want steady drug levels to clear the virus, so anything that nudges levels down is worth respecting.

That said, this is a theoretical concern based on how the drugs behave, not proven cases, and the effect is considered weak. Still, I wouldn't add adrafinil during your treatment course without checking first. Please run it by your pharmacist or prescriber before combining them.

References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES

2 of 2

Sofosbuvir, Velpatasvir also falls under CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES.

Theoretically, adrafinil might reduce the levels and clinical effects of CYP2B6 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP2B6 activity in vitro.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: adrafinil turns into modafinil in your body, and modafinil may gently speed up a liver enzyme called CYP2B6. Since Epclusa (sofosbuvir and velpatasvir) is partly handled by that enzyme, the worry is that adrafinil could lower the amount of medicine in your system. With a hepatitis C treatment, that matters, because steady drug levels over the full course are what clear the virus. Weaker levels could, in theory, make the treatment less effective.

I want to be honest, though: this is a theoretical concern based on lab data, not real patient reports, and modafinil's effect here looks weak. Still, given how important it is to fully cure hep C, please run any adrafinil use past your doctor or pharmacist first.

References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
  3. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Adrafinil Also Interacts With Other Medications

Adrafinil has 1 major, 1,055 moderate known drug interactions in our database — the Sofosbuvir, Velpatasvir one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Adrafinil

Covers the 2,830 medications we’ve checked against Adrafinil. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Sofosbuvir, Velpatasvir

This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sofosbuvir, Velpatasvir page lists 147 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and African Wild Potato (moderate).

By severity: 3 major · 108 moderate · 36 minor.

From our pharmacist’s overview on the Sofosbuvir, Velpatasvir page

“Epclusa (the sofosbuvir and velpatasvir combination) is a finite course meant to cure hepatitis C, so I treat its supplement interactions with genuine seriousness, since anything that lowers the drug's level can undermine the cure itself. St.”

Reviewed by 2 · Jul 18, 2026

Open the Sofosbuvir, Velpatasvir interaction page

One more smart check

Taking Adrafinil as Part of a Dietary Supplement Product? Check It for Interactions

We hold 7 real supplement products containing Adrafinil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Adrafinil. Your product may carry other ingredients that interact with Sofosbuvir, Velpatasvir too, on top of Adrafinil — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Adrafinil and Sofosbuvir, Velpatasvir Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Adrafinil
Top half

#643 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sofosbuvir, Velpatasvir
Steady interest

#2,394 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Adrafinil

What is Adrafinil?

Adrafinil
  • Wakefulness and alertness
  • Fatigue
  • Focus and concentration
  • Cognitive enhancement (nootropic)
  • Daytime sleepiness

Adrafinil is a synthetic compound that the body converts into modafinil, a prescription wakefulness-promoting drug. It is sometimes sold as a nootropic supplement, but it is unregulated, carries real risks (especially to the liver), and is banned in some sports and countries. Talk with a doctor or pharmacist before using it.

Read the full Adrafinil monograph & all interactions
Medication

About Sofosbuvir and Velpatasvir

What Is Sofosbuvir and Velpatasvir Used For?

Brand name: Epclusa

Sofosbuvir and velpatasvir treats chronic hepatitis C virus (HCV) infection caused by genotypes 1, 2, 3, 4, 5, or 6 — covering all the major strains. It is approved for adults and children 3 years of age and older, whether or not they have cirrhosis (liver scarring).

It is used on its own in patients without cirrhosis or with compensated cirrhosis (where the liver is scarred but still functioning). In patients with decompensated cirrhosis (more advanced liver disease where the liver is no longer coping), it is used in combination with another medicine called ribavirin. Epclusa is a brand that is also available as oral pellets for younger children.

See full Sofosbuvir and Velpatasvir drug information
Keep checking

Other Drugs & Adrafinil

Browse every other medication we’ve checked against Adrafinil — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
1,055Moderate
0Minor
1,773No known interaction
Major

1 interaction

Moderate

1,055 interactions

Showing 60 of 1,055 moderate interactions — see all 1,055 on the Adrafinil page.

No interaction 1,773 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Adrafinil and Sofosbuvir, Velpatasvir Together: Common Questions

Can you take Adrafinil with Sofosbuvir, Velpatasvir?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Adrafinil and Sofosbuvir, Velpatasvir?
Sofosbuvir, Velpatasvir belongs to more than one drug category, and Adrafinil interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Adrafinil and Sofosbuvir, Velpatasvir interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.