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

Key takeaways

Harvoni (ledipasvir/sofosbuvir) and Rebetol (ribavirin) are both antiviral medications used to treat hepatitis C. Harvoni is a combination medication that is a first-choice treatment for certain types of hepatitis C, while Rebetol is used with other antivirals for harder-to-treat cases. Harvoni is taken once daily, whereas Rebetol is taken twice daily with food. Harvoni is available as a generic and can be used in children as young as 3 years old, while Rebetol is also available as a generic and can be used in children, but it has more side effects. Common side effects of Harvoni include headache and tiredness, while Rebetol can cause anemia and serious side effects like vision problems and breathing issues. Harvoni interacts with medications like amiodarone and some HIV antiretrovirals, while Rebetol should not be used with azathioprine due to blood cell count issues. Harvoni is not recommended with heartburn medications, and Rebetol is not safe during pregnancy.

Harvoni

(ledipasvir / sofosbuvir)

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Ribavirin

(Rebetol)

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Summary for Harvoni

Prescription only

Harvoni (ledipasvir / sofosbuvir) is a combination medication containing two antiviral medications, ledipasvir and sofosbuvir (Sovaldi). It is a first-choice treatment option for hepatitis C for certain types of people.

Indications for Harvoni

Hepatitis C infection genotype 1, 4, 5, and 6

Pros and Cons for Harvoni

Pros

Taking the medication for 6 months or less is very effective against hepatitis C
Few side effects; most common are stomachache, tiredness, and headache
Can be used in children age 3 years or older
Available as a generic, which can be more affordable
Available as an oral pellet for people who can't swallow the tablet or need their dose lowered

Cons

Heartburn and stomach acid-lowering medications can lower the amount of Harvoni (ledipasvir / sofosbuvir) in your body
Not a good option for people taking amiodarone, because the combination can cause slow heart rate
Doesn't treat all the types of hepatitis C like other antiviral combos, such as Epclusa or Mavyret
Interacts with some HIV antiretroviral medications
Some people who have hepatitis B and C have had their hepatitis B come back after taking hepatitis C treatment

Common Side Effects for Harvoni

Headache (14%)
Fatigue or tiredness (13%)
Nausea (7%)

Warnings for Harvoni

HEPATITIS B REACTIVATION
SLOW HEART RATE
RIBAVIRIN RISKS

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.