Drug & supplement interaction

Zizyphus + Sofosbuvir, Velpatasvir, Voxilaprevir

Sofosbuvir, Velpatasvir, Voxilaprevir brand name: Vosevi.

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

Zizyphus has a moderate interaction with Sofosbuvir, Velpatasvir, Voxilaprevir. Theoretically, zizyphus might decrease the levels and clinical effects of drugs metabolized by CYP1A2.

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

Zizyphus and Sofosbuvir, Velpatasvir, Voxilaprevir

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Why this applies to Sofosbuvir, Velpatasvir, Voxilaprevir

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

Theoretically, zizyphus might decrease the levels and clinical effects of drugs metabolized by CYP1A2.
Animal research shows that zizyphus induces CYP1A2 enzymes. However, this effect 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 your hep C combo Vosevi (sofosbuvir, velpatasvir, and voxilaprevir). On paper, zizyphus may rev up a liver enzyme called CYP1A2, which could speed up how quickly certain medicines are cleared from your body. If that happened with your treatment, the worry would be lower drug levels and a weaker punch against the virus, which matters a lot when you're trying to clear hepatitis C.

That said, I want to be straight with you: this is based only on animal and lab data, and it hasn't actually been seen in people. It's more of a theoretical caution than a proven problem. Since finishing a full course of this medicine the right way is so important, just run any zizyphus supplement past your pharmacist or doctor before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Jing XY, Peng YR, Wang XM, Duan JA. Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats. Chin J Nat Med. 2015 Aug;13(8):588-94. 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

Zizyphus Also Interacts With Other Medications

Zizyphus has 468 moderate known drug interactions in our database — the Sofosbuvir, Velpatasvir, Voxilaprevir one above is one of them. If you take anything else, check it against the full list below.

Moderate 468 No known interaction 2,362 (incl. Sofosbuvir, Velpatasvir, Voxilaprevir)
Taking anything else?

Check Another of Your Medications Against Zizyphus

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

Everything else you take

See Every Supplement That Interacts With Sofosbuvir, Velpatasvir, Voxilaprevir

This page covers Zizyphus 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

How much people look this up

Where Zizyphus 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 Zizyphus
Top half

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

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

#512 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 Zizyphus

What is Zizyphus?

Zizyphus
  • Sleep problems and insomnia
  • Anxiety and stress
  • Digestive support
  • General nutrition (vitamin C and fiber)
  • Constipation

Zizyphus (jujube) is an edible fruit and traditional remedy used mainly for sleep, anxiety, and digestion. The fruit is a nutritious food, but human evidence for its medicinal benefits is limited and mostly preliminary. If you want to try a supplement form, talk with your pharmacist or doctor first, especially if you are pregnant, breastfeeding, or taking other medicines.

Read the full Zizyphus 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 without cirrhosis (liver scarring) or with compensated cirrhosis (mild liver scarring, Child-Pugh A). It is specifically for people who have already tried an HCV treatment that did not fully work.

Vosevi is approved for adults with HCV genotypes 1, 2, 3, 4, 5, or 6 who were previously treated with a regimen containing an NS5A inhibitor. It is also approved for adults with genotype 1a or 3 who were previously treated with sofosbuvir without an NS5A inhibitor. Note: Vosevi has not been shown to offer additional benefit over sofosbuvir/velpatasvir for adults with genotype 1b, 2, 4, 5, or 6 who received sofosbuvir without an NS5A inhibitor.

See full Sofosbuvir, Velpatasvir, and Voxilaprevir drug information
Keep checking

Other Drugs & Zizyphus

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

0Major
468Moderate
0Minor
2,361No known interaction
468 Moderate 2,361 No interaction
Moderate

468 interactions

Showing 60 of 468 moderate interactions — see all 468 on the Zizyphus page.

No interaction 2,361 drugs checked — show the list

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

Showing the 60 most looked-up of 2,361 medications checked with no known interaction — see the full Zizyphus list.

See the full Zizyphus 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
Zizyphus 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 Zizyphus and Sofosbuvir, Velpatasvir, Voxilaprevir Together: Common Questions

Can you take Zizyphus 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.
How serious is the Zizyphus 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 Zizyphus?

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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.