Neem - Vosevi (Sofosbuvir, Velpatasvir, Voxilaprevir) Interaction
Herbal: Neem
Also Known As: Azadirachta indica, Arishta, Arishtha, Bead Tree, Holy Tree, Huile de Neem, Indian Lilac, Indian Neem, Lilas des Indes, Lilas de Perse, Margosa, Margosa Tree, Margousier, Margousier à Feuilles de Frêne, Margousier d'Inde, Neem Oil, Neem Tree, Nim, Nimb, Nimba, Persian Lilac
Drug: Sofosbuvir, Velpatasvir, Voxilaprevir
Brand names:
Vosevi
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 11, 2025
Interaction Details
Sofosbuvir, Velpatasvir, Voxilaprevir is classified as belonging to the following category: Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, neem leaf extract might increase the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that neem leaf extract inhibits CYP1A2 enzymes. So far, this reaction has not been reported in humans.
Interaction Rating
Likelihood of Occurrence
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
References
- Amaeze O, Marques ES, Wei W, et al. Evaluation of Nigerian Medicinal Plants Extract on Human P-glycoprotein and Cytochrome P450 Enzyme Induction: Implications for Herb-drug Interaction. Curr Drug Metab. 2021;22(14):1103-1113.
Interaction Details
Sofosbuvir, Velpatasvir, Voxilaprevir is classified as belonging to the following category: P-Glycoprotein Substrates
Theoretically, neem leaf extract might increase the levels and clinical effects of P-glycoprotein substrates.
In vitro research shows that neem leaf methanol extract inhibits renal P-glycoprotein transport activity. So far, this reaction has not been reported in humans.
Interaction Rating
Likelihood of Occurrence
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
References
- Amaeze O, Marques ES, Wei W, et al. Evaluation of Nigerian Medicinal Plants Extract on Human P-glycoprotein and Cytochrome P450 Enzyme Induction: Implications for Herb-drug Interaction. Curr Drug Metab. 2021;22(14):1103-1113.
Interaction Details
Sofosbuvir, Velpatasvir, Voxilaprevir is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, neem leaf extract might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that neem leaf methanol extract inhibits CYP3A4 enzymes. So far, this reaction has not been reported in humans.
Interaction Rating
Likelihood of Occurrence
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
References
- Amaeze O, Eng H, Horlbogen L, Varma MVS, Slitt A. Cytochrome P450 Enzyme Inhibition and Herb-Drug Interaction Potential of Medicinal Plant Extracts Used for Management of Diabetes in Nigeria. Eur J Drug Metab Pharmacokinet. 2021;46(3):437-450.
Interaction Details
Sofosbuvir, Velpatasvir, Voxilaprevir is classified as belonging to the following category: Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, neem leaf extract might increase the levels and clinical effects of CYP2C8 substrates.
In vitro research shows that neem leaf methanol extract inhibits CYP2C8 enzymes. So far, this reaction has not been reported in humans.
Interaction Rating
Likelihood of Occurrence
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
References
- Amaeze O, Eng H, Horlbogen L, Varma MVS, Slitt A. Cytochrome P450 Enzyme Inhibition and Herb-Drug Interaction Potential of Medicinal Plant Extracts Used for Management of Diabetes in Nigeria. Eur J Drug Metab Pharmacokinet. 2021;46(3):437-450.
Neem Overview
Neem (Azadirachta indica) is a tree native to India and is widely cultivated in tropical and subtropical regions around the world. The leaves, seeds, and bark of the neem tree are often used in herbal remedies and are thought to have antioxidant, anti-inflammatory, and antimicrobial properties.
Neem is used in traditional medicine to treat a variety of conditions, including skin conditions, digestive disorders, respiratory problems, and fever. It is also used as a natural remedy for anxiety, stress, and other ailments. Additionally, it has been used in aromatherapy to improve mood and reduce stress.
The leaves of the tree are used as a natural pesticide and are believed to be effective at controlling a variety of pests, including insects, nematodes, and fungi. It is approved for use as a pesticide in the United States by the Environmental Protection Agency (EPA).
Sofosbuvir, Velpatasvir, Voxilaprevir Overview
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The combination of sofosbuvir, velpatasvir, and voxilaprevir is used to treat chronic (long-term) hepatitis C infection (swelling of the liver caused by a virus) in adults who have already received other HCV treatments. Sofosbuvir is a non-nucleoside NS5B polymerase inhibitor. It works by decreasing the amount of hepatitis C virus in the body. Velpatasvir is a hepatitis C virus (HCV) NS5A inhibitor. It works by stopping the virus that causes hepatitis C from spreading inside the body. Voxilaprevir is in a class of medications called HCV NS3/4A protease inhibitors. It works by decreasing the amount of HCV in the body.
Neem - More Interactions
Neem interacts with 976 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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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
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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