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

Key takeaways

Harvoni (ledipasvir/sofosbuvir) and Mavyret (glecaprevir/pibrentasvir) are both antiviral medications used to treat hepatitis C, but they have some differences. Harvoni is available in both brand and generic forms, while Mavyret is only available as a brand. Harvoni treats hepatitis C genotypes 1, 4, 5, and 6, whereas Mavyret treats all six genotypes. Harvoni is typically taken once a day for 8 to 12 weeks, while Mavyret is usually taken once a day for 8 to 16 weeks, depending on your treatment history. Mavyret can be taken with antacids and other heartburn medications, unlike Harvoni. Both medications can reactivate hepatitis B in people with a history of the infection, but Mavyret is not recommended for those with severe liver problems. Common side effects for both include headache, tiredness, and nausea.

Harvoni

(ledipasvir / sofosbuvir)

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Mavyret

(glecaprevir / pibrentasvir)

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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 Mavyret

Prescription only

Mavyret is a combination medication that contains two antivirals, glecaprevir and pibrentasvir. It's a first-choice tratment for both early (acute) and long-term (chronic) hepatitis C. This medication comes as tablets and oral pellets for people 3 years and older. You take your dose by mouth once a day with food. It's taken for 8 to 16 weeks, depending on the type of hepatitis C you have, your liver health, and past treatments. Side effects include headache, tiredness, and nausea.

Indications for Mavyret

Acute or chronic hepatitis C genotype 1, 2, 3, 4, 5, or 6 infection in people ages 3 years and older
Hepatitis C genotype 1 infection in people age 3 years and older who were previously treated with an NS5A inhibitor or an HCV protease inhibitor (not both)

Pros and Cons for Mavyret

Pros

Works against six types of hepatitis C
Only need to take once a day
Available as oral pellets that can be mixed with soft food for young children

Cons

Must take multiple tablets or use multiple packets of oral pellets at one time for the full dose
Risk of making hepatitis B come back if you've had it before
Can interact with HIV medications, statins, blood thinners, and other medications

Common Side Effects for Mavyret

Headache (16%)
Fatigue (11%)
Nausea (9%)
Diarrhea (7%)

Note: Side effects were from adults without cirrhosis who were treated for hepatitis C for the first time. Side effects might be different for people with cirrhosis or for children.

Warnings for Mavyret

Risk of hepatitis B flareup in certain people
Risk of worsening liver health
Drug interactions that can make Mavyret (glecaprevir / pibrentasvir) not work as well