Drug & supplement interaction

Red Clover + Sofosbuvir, Velpatasvir, Voxilaprevir

Sofosbuvir, Velpatasvir, Voxilaprevir brand name: Vosevi.

Minor Interaction
The bottom line Minor

Sofosbuvir, Velpatasvir, Voxilaprevir falls into 2 drug categories that Red Clover can interact with; the most serious is rated minor. Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.

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

Red Clover and Sofosbuvir, Velpatasvir, Voxilaprevir

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

Why Are There 2 Interactions?

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

Minor

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 2

Why this applies to Sofosbuvir, Velpatasvir, Voxilaprevir

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

Theoretically, red clover might increase levels of drugs metabolized by CYP1A2; however, a small clinical study found no effect.
In vitro evidence shows that red clover inhibits CYP1A2. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of caffeine, a CYP1A2 probe substrate.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the short version: this is a very weak, mostly theoretical concern. In lab dishes, red clover can slow down an enzyme called CYP1A2, and the idea is that blocking that enzyme could let certain drugs build up. But when researchers actually tested red clover in people, they saw no real change in how the body handled a CYP1A2 test substance.

On top of that, Vosevi (sofosbuvir, velpatasvir, voxilaprevir) doesn't really lean on CYP1A2 to be cleared, so this particular pathway isn't a meaningful route for your hepatitis C medicine. I wouldn't expect red clover to change how well your treatment works or to add side effects through this. Still, because finishing your full course matters, it's worth running any supplement past your pharmacist or doctor first.

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. Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

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

Theoretically, red clover might increase levels of drugs metabolized by CYP3A4; however, a small clinical study found no effect.
In vitro evidence shows that red clover might inhibit CYP3A4 isoenzymes. However, a clinical study in healthy postmenopausal individuals shows that taking red clover capsules standardized to contain 60 mg isoflavones twice daily for 14 days does not affect the pharmacokinetics of alprazolam, a CYP3A4 probe substrate.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the gist for anyone on Vosevi (sofosbuvir, velpatasvir, and voxilaprevir) wondering about red clover. Part of this combination, especially velpatasvir and voxilaprevir, passes through a liver enzyme called CYP3A4. In a test tube, red clover's isoflavones looked like they might slow that enzyme down, which in theory could let a bit more of the medicine build up. More buildup could mean a slightly higher chance of things like headache, nausea, tiredness, or diarrhea.

But the real-world evidence is reassuring. A small human study using a standardized red clover dose found no meaningful change in a CYP3A4 test drug, so this concern is mostly theoretical. Since finishing your full hepatitis C course matters a lot, I'd still mention any supplement to your pharmacist or doctor before adding it.

References
  1. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  2. 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
  3. Chen L, Choi J, Leonard SW, et al. No Clinically Relevant Pharmacokinetic Interactions of a Red Clover Dietary Supplement with Cytochrome P450 Enzymes in Women. J Agric Food Chem. 2020;68(47):13929-13939. 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

Red Clover Also Interacts With Other Medications

Red Clover has 44 moderate, 822 minor 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.

Taking anything else?

Check Another of Your Medications Against Red Clover

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

Everything else you take

See Every Supplement That Interacts With Sofosbuvir, Velpatasvir, Voxilaprevir

This page covers Red Clover 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 Red Clover as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,480 real supplement products containing Red Clover, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Red Clover. Your product may carry other ingredients that interact with Sofosbuvir, Velpatasvir, Voxilaprevir too, on top of Red Clover — 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 Red Clover 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 Red Clover
Top 25%

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

29 days ago today
Medication Sofosbuvir, Velpatasvir, Voxilaprevir
Steady interest

#2,251 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 Red Clover

What is Red Clover?

Red Clover
  • Menopause symptoms (hot flashes)
  • High cholesterol
  • Bone health/osteoporosis
  • Skin and hair concerns
  • Women's health

Red clover is a plant rich in isoflavones (plant compounds with weak estrogen-like activity) that is most often used for menopause symptoms like hot flashes. The evidence is mixed and generally weak, with some studies showing modest benefit and others showing none. Because of its hormone-like effects, it's not for everyone—talk with your pharmacist or doctor before trying it, especially if you have a hormone-sensitive condition.

Read the full Red Clover 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 & Red Clover

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

0Major
44Moderate
822Minor
1,963No known interaction
Moderate

44 interactions

Minor

822 interactions

Showing 60 of 822 minor interactions — see all 822 on the Red Clover page.

No interaction 1,963 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

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Pharmacist Counseling Corner

Taking Red Clover and Sofosbuvir, Velpatasvir, Voxilaprevir Together: Common Questions

Can you take Red Clover with Sofosbuvir, Velpatasvir, Voxilaprevir?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Red Clover and Sofosbuvir, Velpatasvir, Voxilaprevir?
Sofosbuvir, Velpatasvir, Voxilaprevir belongs to more than one drug category, and Red Clover 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 Red Clover and Sofosbuvir, Velpatasvir, Voxilaprevir interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

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

Still Have a Question About Sofosbuvir, Velpatasvir, Voxilaprevir and Red Clover?

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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.