Epclusa vs. Ribavirin for Hepatitis C: Important Differences and Potential Risks.

Key takeaways

Epclusa (sofosbuvir/velpatasvir) and ribavirin (Rebetol) are both antiviral medications used to treat chronic hepatitis C, but they have some key differences. Epclusa is a combination of two antiviral drugs and is effective against all six types of hepatitis C, while ribavirin is usually used with other antivirals and is not effective on its own. Epclusa is typically taken once a day, whereas ribavirin must be taken twice a day with food. Ribavirin has a generic form available, which can make it more affordable. However, ribavirin has more severe side effects, such as anemia and potential harm to an unborn baby, and requires regular blood tests. Epclusa, on the other hand, has milder common side effects like headache and fatigue but can interact with many other medications.

Epclusa

(sofosbuvir / velpatasvir)

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Ribavirin

(Rebetol)

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Summary for Epclusa

Prescription only

Epclusa (sofosbuvir / velpatasvir) is a combination medication containing two antiviral medications, sofosbuvir and velpatasvir, that's used to treat chronic hepatitis C in adults and children.

Indications for Epclusa

Chronic hepatitis C infection

Pros and Cons for Epclusa

Pros

Treats all 6 types of hepatitis C
Most people only have to take one pill once a day for 12 weeks
Can be taken with or without food
Most common side effects are usually mild, such as fatigue and headache

Cons

Interacts with many medications including those used for heartburn
Not a good option for people taking amiodarone (Pacerone) because the combination can cause slow heart rate
Some people with severe liver problems who have chronic hepatitis C may need to take it with another antiviral medication called ribavirin
Can reactivate the hepatitis B virus if you have a history of hepatitis B infection

Common Side Effects for Epclusa

Headache
Fatigue

Warnings for Epclusa

Hepatitis B reactivation
Slow heart rate
Ribavirin risks
Interactions with other medications

Summary for Ribavirin

Prescription only

Ribavirin (Rebetol) is an antiviral medication used with other antivirals for the treatment of chronic hepatitis C infection. It has a lot of side effects, so it's usually reserved for people with harder-to-treat chronic hepatitis C infection.

Indications for Ribavirin

Chronic hepatitis C infection
Chronic hepatitis C with HIV coinfection (tablets only)

Pros and Cons for Ribavirin

Pros

Higher chance of cure when added to other antiviral medications for hard-to-treat chronic hepatitis C
Available as generic which can be more affordable
Can be used in both children and adults
Treatment is usually shorter than 1 year.

Cons

Must be taken two times every day with food
Can cause low red blood cells and is not a good choice for people with a history of heart problems
Can harm an unborn baby and can't be used in pregnant women or male partners of women who can become pregnant
Not effective if used by itself; must be combined with other antivirals

Common Side Effects for Ribavirin

In clinical trials ribavirin (Rebetol) was always given with another medication called interferon. It's possible that many of these side effects were caused by interferon.