What is sofosbuvir and velpatasvir? What is sofosbuvir and velpatasvir used for?
- Epclusa is an oral tablet containing two drugs used for the treatment of
chronic infection with the hepatitis C virus (HCV), genotype 1,2,3,4, 5, or 6 in
adults. The components belong to a class of drugs called direct-acting antiviral
agents. Similar drugs include- boceprevir (Victrelis),
- sofosbuvir (Sovaldi),
- simeprevir (Olysio),
- telaprevir (Incivek),
- Viekira Pak (ombitasvir, paritaprevir, ritonavir, dasabuvir),
and - Harvoni
(ledipasvir and sofosbuvir).
- Epclusa contains velpatasvir and sofosbuvir. Sofosbuvir is converted to an
active form in the body before it is effective. The active form of sofosbuvir
directly blocks replication of the HVC by interfering with a hepatitis C virus
enzyme called NS5B. Velpatasvir is an inhibitor of another hepatitis C virus
enzyme called NS5A, which also is needed for viral replication. Both drugs in
Epclusa interfere with enzymes needed by hepatitis C virus to multiply and make
new viruses, thus reducing the overall viral load. - Epclusa does not require administration with interferons or ribavirin (Rebetol)
except when used to treat patients with decompensated cirrhosis. In some
clinical studies, 98%-100% of patients were cured after 12 weeks of Epclusa
treatment. Cure was defined as undetectable levels of hepatitis C virus in the
blood when measured three months after the completion of treatment. - Epclusa was approved by the FDA in June, 2016.
What brand names are available for sofosbuvir and velpatasvir?
Epclusa
Is sofosbuvir and velpatasvir available as a generic drug?
No
Do I need a prescription for sofosbuvir and velpatasvir?
Yes
What are the uses for sofosbuvir and velpatasvir?
- Epclusa is used to treat chronic hepatitis C virus genotype 1, 2,3,4,5 or 6
infection in adults without cirrhosis or with compensated cirrhosis. - It also may be combined with ribavirin (Rebetol) for treatment of adults with
decompensated cirrhosis.
What are the side effects of sofosbuvir and velpatasvir?
Common side effects of Epclusa include:
Other side effects of Epclusa include:
Other less common side effects of Epclusa include:
- Increased blood levels of lipase
- Increased blood levels of creatinine kinase
- Increased blood levels of indirect bilirubin
Possible serious side effects include:
- There is an increased risk of low heart rate (bradycardia) when Epclusa is
combined with amiodarone (Cordarone).
What is the dosage for Epclusa sofosbuvir and velpatasvir?
- The recommended dose of Epclusa is one tablet taken once daily with or
without food. - Patients without cirrhosis and patients with compensated cirrhosis are
treated with Epclusa alone for 12 weeks. - Patients with decompensated cirrhosis are treated with Epclusa plus ribavirin
for 12 weeks.
Which drugs or supplements interact with sofosbuvir and velpatasvir?
- Acid reducing agents that are commonly used to treat heartburn, indigestion,
and GERD may decrease the effectiveness of Epclusa treatment by decreasing blood
levels of velpatasvir. Examples of acid reducing agents include antacids,
histamine 2 receptor antagonists, for example, famotidine (Pepcid), and proton
pump inhibitors (PPIs), for example, omeprazole (Prilosec). - Antacid and Epclusa administration should be separated by 4 hours. Doses of
histamine 2 receptor antagonists equivalent to famotidine 40 mg twice daily or
less and doses of proton pump inhibitors equivalent to 20 mg of omeprazole or
lower may be given at the same time as Epclusa. - Co-administration of Epclusa and amiodarone is not recommended because the
combination may cause serious heart-related side effects including symptomatic
bradycardia (slow heart rate). - Anti-seizure medications including carbamazepine (Tegretol), phenytoin
(Dilantin), phenobarbital (Luminal), and oxcarbazepine (Trileptal) may increase
the breakdown of Epclusa, leading to reduced therapeutic effectiveness. - Taking St. John’s Wort or rifampin with Epclusa may also reduce the
effectiveness of treatment and is not recommended. - Certain medication used to treat tuberculosis (TB) infection may decrease the
effectiveness of Epclusa treatment. Patients taking rifampin, rifabutin, or
rifapentine should consult with their doctor or pharmacist before starting
Epclusa. - Co-administration of Epclusa with rosuvastatin (Crestor) or atorvastatin
(Lipitor) cholesterol lowering medications may significantly increase the blood
concentration of rosuvastatin or atorvastatin and increase the risk of side
effects such as serious muscle injury. - Drug interactions between Epclusa and certain HIV antiretroviral therapies
such as efavirenz (Sustiva), tenofovir (Viread), tipranavir (Aptivus), and
ritonavir (Norvir) have also been reported. Patients receiving HIV treatment are
advised to consult with their doctor or pharmacist before starting Epclusa.
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Is Epclusa sofosbuvir and velpatasvir safe to take if I’m pregnant or breastfeeding?
- Although no fetal adverse events were reported in animal studies, adequate
studies of Epclusa treatment in
pregnant women are lacking. Therefore, Epclusa
should be used during pregnancy only if the potential benefit justifies the
potential risk to the fetus. However, ribavirin which may be combined with
Epclusa should not be used by pregnant women or their male partners. - It is not known whether Epclusa is excreted into human milk. Due to the lack
of conclusive safety data, Epclusa should be used cautiously while
breastfeeding.
What else should I know about Epclusa sofosbuvir and velpatasvir?
What preparations of Epclusa sofosbuvir and velpatasvir are available?
Fixed dose oral tablets containing 400 mg sofosbuvir and 100 mg
velpatasvir.
How should I keep Epclusa sofosbuvir and velpatasvir stored?
Epclusa should be stored below 30 C (86 F) and in its original
container.