Drug & supplement interaction

Fo-ti + Sofosbuvir, Velpatasvir

Sofosbuvir, Velpatasvir brand name: Epclusa.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Sofosbuvir, Velpatasvir falls into 3 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fo-ti and Sofosbuvir, Velpatasvir

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Fo-ti interacts with whole categories of medication. Sofosbuvir, Velpatasvir falls into 3 of those categories, so it can interact with Fo-ti in 3 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 3

Why this applies to Sofosbuvir, Velpatasvir

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

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.
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 situation with Epclusa (sofosbuvir and velpatasvir) and Fo-ti. Velpatasvir is partly cleared by an enzyme called CYP3A4. In test-tube studies, Fo-ti looked like it might slow that enzyme down, which could in theory let velpatasvir build up a bit higher than usual. If that happened, you might notice more headache, tiredness, or nausea.

That said, I want to keep this in perspective. This is only lab-dish data, animal studies didn't agree, and it has never actually been reported in people. So I'd call it more theoretical than proven. The bigger concern is that processed Fo-ti has been linked to liver injury, and you're already treating a liver condition. Please loop in your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;1 PubMed
  2. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  3. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Moderate

CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES

2 of 3

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

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.
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 honest picture: the concern on file is that Fo-ti might block an enzyme called CYP2B6, which in theory could let drugs cleared by that enzyme build up a bit. But this is based only on lab and animal work, and it has never actually been reported in people. On top of that, Epclusa (sofosbuvir and velpatasvir) isn't mainly handled by CYP2B6, so I'd put this interaction pretty low on the worry list.

The bigger issue with Fo-ti, especially the processed root, is that it has been linked to liver injury. Since you're treating hepatitis C and protecting your liver, that overlap matters more than the enzyme question. Please run any Fo-ti use past your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. DOI
  2. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

3 of 3

Sofosbuvir, Velpatasvir also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.
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 of it: in a test tube, Fo-ti looks like it can slow down an enzyme called CYP2C8. Since Epclusa (sofosbuvir/velpatasvir) is partly handled by that pathway, the theory is that Fo-ti could let a bit more of the medicine build up, which might mean more of its usual effects or side effects like headache, tiredness, or nausea. Honestly, though, this has only been seen in lab studies, not in real people, so I'd call it more of a maybe than a sure thing.

What does worry me more is that Fo-ti itself has been tied to liver injury, and you're already taking a medicine to heal your liver. That's the bigger reason to check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Xing Y, Yu Q, Zhou L, et al. Cytochrome P450-mediated herb-drug interaction (HDI) of Polygonum multiflorum Thunb. based on pharmacokinetic studies and in vitro inhibition assays. Phytomedicine 2023;112:154710. PubMed

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

Fo-ti Also Interacts With Other Medications

Fo-ti has 1,256 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.

Moderate 1,256 No known interaction 1,574 (incl. Sofosbuvir, Velpatasvir)
Taking anything else?

Check Another of Your Medications Against Fo-ti

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

Everything else you take

See Every Supplement That Interacts With Sofosbuvir, Velpatasvir

This page covers Fo-ti 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 Adrafinil (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 Fo-ti as Part of a Dietary Supplement Product? Check It for Interactions

We hold 976 real supplement products containing Fo-ti, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Fo-ti. Your product may carry other ingredients that interact with Sofosbuvir, Velpatasvir too, on top of Fo-ti — 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 Fo-ti 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 Fo-ti
Top 25%

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

29 days ago today
Medication Sofosbuvir, Velpatasvir
Steady interest

#2,698 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 Fo-ti

What is Fo-ti?

  • Anti-aging and longevity
  • Hair graying and hair loss
  • General tonic for vitality
  • Constipation
  • High cholesterol

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these benefits is limited, and processed Fo-ti has been linked to reports of liver injury, so caution and professional guidance are important.

Read the full Fo-ti 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 & Fo-ti

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

0Major
1,256Moderate
0Minor
1,573No known interaction
1,256 Moderate 1,573 No interaction
Moderate

1,256 interactions

Showing 60 of 1,256 moderate interactions — see all 1,256 on the Fo-ti page.

No interaction 1,573 drugs checked — show the list

We also checked Fo-ti against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,573 medications checked with no known interaction — see the full Fo-ti list.

See the full Fo-ti interactions page
See every supplement checked against Sofosbuvir, Velpatasvir, ranked by severity
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
Fo-ti monograph › Uses, safety, and every drug interaction in one place Sofosbuvir, Velpatasvir supplement interactions › Every supplement checked against Sofosbuvir, Velpatasvir, ranked by severity Sofosbuvir and Velpatasvir drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Fo-ti and Sofosbuvir, Velpatasvir Together: Common Questions

Can you take Fo-ti 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 3 interactions listed for Fo-ti and Sofosbuvir, Velpatasvir?
Sofosbuvir, Velpatasvir belongs to more than one drug category, and Fo-ti 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 Fo-ti 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

Still Have a Question About Sofosbuvir, Velpatasvir and Fo-ti?

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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.