Drug & supplement interaction

Fo-ti + Sofosbuvir, Velpatasvir, Voxilaprevir

Sofosbuvir, Velpatasvir, Voxilaprevir brand name: Vosevi.

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

Sofosbuvir, Velpatasvir, Voxilaprevir falls into 4 drug categories that Fo-ti can interact with; the most serious is rated moderate. Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fo-ti and Sofosbuvir, Velpatasvir, Voxilaprevir

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Fo-ti interacts with whole categories of medication. Sofosbuvir, Velpatasvir, Voxilaprevir falls into 4 of those categories, so it can interact with Fo-ti in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 4

Why this applies to Sofosbuvir, Velpatasvir, Voxilaprevir

Sofosbuvir, Velpatasvir, Voxilaprevir falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Fo-ti interacts with.

Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti 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 with Vosevi (the sofosbuvir, velpatasvir, voxilaprevir combo) and Fo-ti. The concern on file is that Fo-ti may either slow down or speed up an enzyme called CYP1A2, which can play a role in handling some medications. The catch is that this is based only on lab and animal studies, not real people, so we genuinely don't know if it matters in practice. Different Fo-ti extracts even pushed in opposite directions in those studies.

My bigger worry is actually simpler: Fo-ti has been linked to liver injury, and Vosevi is treating your liver. I'd hold off and check with your prescriber or pharmacist before combining them, just to keep your treatment on track and your liver protected.

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 3A4 (CYP3A4) SUBSTRATES

2 of 4

Sofosbuvir, Velpatasvir, Voxilaprevir also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

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 practical picture with Vosevi (sofosbuvir, velpatasvir, voxilaprevir). In lab dishes, fo-ti appears able to block an enzyme called CYP3A4, which helps clear part of this combination, especially the velpatasvir and voxilaprevir pieces. If that blocking happened in real life, those drug levels could climb a bit, which might mean more of the usual side effects like headache, tiredness, nausea, or diarrhea.

The honest part: this is only test-tube and animal data, the findings even conflict, and it has never actually been reported in people. So I wouldn't panic. That said, fo-ti itself has been tied to liver injury, and you're taking Vosevi for your liver, so I'd really run this past your pharmacist or doctor 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

3 of 4

Sofosbuvir, Velpatasvir, Voxilaprevir 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 for Vosevi (sofosbuvir, velpatasvir, voxilaprevir). The interaction on file says Fo-ti might block an enzyme called CYP2B6, which could theoretically let drugs cleared that way build up a bit. The thing is, this is based only on lab and animal studies, and it has never actually been reported in people. Vosevi is also handled mainly by other pathways and transporters, so CYP2B6 isn't its main exit route.

My bigger concern is different: Fo-ti, especially the raw or unprocessed root, has been linked to liver injury, and you're taking Vosevi precisely to heal your liver from hepatitis C. That's worth a real conversation. Please loop in your pharmacist or doctor before mixing the two, and don't stop your therapy on your own.

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

4 of 4

Sofosbuvir, Velpatasvir, Voxilaprevir 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 for Vosevi (sofosbuvir, velpatasvir, voxilaprevir). Lab studies hint that Fo-ti might block an enzyme called CYP2C8, which helps clear part of this combo (voxilaprevir touches that pathway). If that enzyme is slowed, drug levels could creep up a bit, which in theory might mean more chance of side effects like headache, nausea, tiredness, or diarrhea.

I want to be honest though: this is only a theoretical concern from test-tube work, and it has never actually been reported in real patients. The bigger reason I'd pump the brakes is that processed Fo-ti has been tied to liver injury, and you're already treating your liver with this medicine. Please loop in 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, Voxilaprevir 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, Voxilaprevir)
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, Voxilaprevir

This page covers Fo-ti only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sofosbuvir, Velpatasvir, Voxilaprevir page lists 173 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 · 130 moderate · 40 minor.

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

“Vosevi (sofosbuvir, velpatasvir, and voxilaprevir) cures hepatitis C over a single short course, and that is exactly why I would be genuinely careful with supplements while taking it. Anything that drags its blood levels down can cost you the cure itself.”

Reviewed by 2 · Jul 18, 2026

Open the Sofosbuvir, Velpatasvir, Voxilaprevir 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, Voxilaprevir 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, Voxilaprevir 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%

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

29 days ago today
Medication Sofosbuvir, Velpatasvir, Voxilaprevir
Top 25%

#667 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, Velpatasvir, and Voxilaprevir

What Is Sofosbuvir, Velpatasvir, and Voxilaprevir Used For?

Brand name: Vosevi

Vosevi is used to treat chronic hepatitis C virus (HCV) infection in adults who do not have cirrhosis or who have compensated cirrhosis (mild liver scarring that is still functioning). It is specifically for people who have already been treated with an HCV regimen before and need a different option.

Vosevi is approved for adults with HCV genotype 1, 2, 3, 4, 5, or 6 who previously took a medicine that included an NS5A inhibitor. It is also approved for adults with genotype 1a or 3 who previously took sofosbuvir without an NS5A inhibitor.

See full Sofosbuvir, Velpatasvir, and Voxilaprevir 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, Voxilaprevir, 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, Voxilaprevir supplement interactions › Every supplement checked against Sofosbuvir, Velpatasvir, Voxilaprevir, ranked by severity Sofosbuvir, Velpatasvir, and Voxilaprevir 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, Voxilaprevir Together: Common Questions

Can you take Fo-ti with Sofosbuvir, Velpatasvir, Voxilaprevir?
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 4 interactions listed for Fo-ti and Sofosbuvir, Velpatasvir, Voxilaprevir?
Sofosbuvir, Velpatasvir, Voxilaprevir 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, Voxilaprevir 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, Voxilaprevir 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.