Harvoni vs. Epclusa for Hepatitis C: 5 Similarities and Differences to Consider

Hepatitis C is a viral infection that affects the liver. Without treatment, it can cause serious liver damage and lead to liver cancer and diabetes, as well as other health problems. The good news is that there are a number of safe and effective treatment options that can cure hepatitis C in most people. Two common options are Harvoni (ledipasvir / sofosbuvir) and Epclusa (sofosbuvir / velpatasvir). But when it comes to Harvoni versus Epclusa, what’s the difference between them? Is one better than the other? Here’s what you need to know.

1. Harvoni and Epclusa treat hepatitis C in a similar way

Harvoni and Epclusa are both direct-acting antiviral medications (DAAs). DAAs work by blocking certain enzymes (proteins) the hepatitis C virus needs in order to spread in the body. Over time, this reduces the amount of hepatitis C virus in your body, known as the viral load. Hepatitis C is considered cured when the viral load is no longer detectable. This is also known as achieving a sustained virologic response (SVR). It’s typically tested about 12 weeks after your finish treatment.

Harvoni and Eplucosa are both combination medications that contain two different active ingredients. They both contain sofosbuvir, the active ingredient found in Sovaldi (another DAA medication). But their second ingredients are different. Harvoni contains ledipasvir, while Epclusa contains velpatasvir. Although they work in the same way to treat hepatitis, the different ingredients target different types of hepatitis C virus — more on that next.

2. Epclusa treats more types of hepatitis C than Harvoni

One of the main differences between Epclusa and Harvoni is that they each treat different types of hepatitis C.

There are six different types of the hepatitis C virus. They’re referred to as genotypes 1 through 6. Harvoni is only effective for genotypes 1, 4, 5, and 6. Epclusa, on the other hand, treats all 6 genotypes. Epclusa’s broader coverage makes it a first-choice option if you’re treating hepatitis C for the first time.

Harvoni and Epclusa are both considered highly effective when it comes to curing hepatitis C. One study showed that Epclusa may be slightly more effective. But how well these medications work depends on a variety of factors, such as your other health conditions and if you’ve been treated for hepatitis C in the past. Your prescriber will make the best choice for you based on your medical history.

EXPERT PICKS: WHAT TO READ NEXT

• Alphabet soup: Learn the differences between hepatitis A, B, C, D, and E, as well as how to protect your health.

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• Hepatitis C medications: Several medications are available to treat hepatitis C. We’ve covered the most common options and when they’re prescribed.

3. Harvoni and Epclusa come in similar dosage forms

Harvoni and Epclusa are both FDA approved to treat hepatitis C in adults and children as young as 3 years old. Both medications are taken once a day, with or without food.

Harvoni and Epclusa both come in oral tablets as well as oral pellets. The pellets are an easier option for children or adults who have trouble swallowing pills. They can be swallowed on their own or mixed with soft food, such as pudding.

The available doses of both medications are shown in the chart below.

Harvoni and Epclusa dosages for children are based on body weight. Your pediatrician will let you know the right dosage for your child.

4. Harvoni’s treatment length may differ from Epclusa’s

Epclusa typically requires daily treatment for 12 weeks (about 3 months). But Harvoni’s treatment time may vary based on several factors.

Your prescriber may recommend just 8 weeks (about 2 months) of Harvoni treatment if you have the genotype 1 form of hepatitis C and the amount of virus in your body is low. On the other hand, you may need up to 24 weeks (about 6 months) of Harvoni treatment if you have severe liver scarring and have received hepatitis C treatment in the past. Otherwise, most people take Harvoni for 12 weeks.

Depending on your hepatitis C genotype and other health conditions, one treatment may be a better option for you than another when it comes to how long you’ll have to take it. Your healthcare team can help determine the best fit for your needs.

5. Harvoni and Epclusa have similar side effects

Harvoni and Epclusa contain similar active ingredients. So they also cause similar side effects. Common side effects of both medications include fatigue, nausea, and diarrhea. They’re typically mild and go away on their own once your treatment is finished. In the meantime, taking your medication with food and staying hydrated can help.

Both Harvoni and Epclusa carry a boxed warning about the risk of hepatitis B infection while you’re taking them. This is the FDA’s most serious medications warning. These medications can reactivate hepatitis B if you’ve had it in the past, which can lead to serious liver problems. In most cases, your prescriber will screen you for hepatitis B before you start treatment. But let them know right away if signs or symptoms of hepatitis B appear, such as:

• Fever

• Jaundice (yellowing of the eyes or skin)

• Dark-colored urine

• Stomach pain

Talk to your healthcare team if you have questions about what side effects to expect with your chosen hepatitis C treatment.

Good to know: In some cases, you’ll need to take ribavirin (Rebetol), another antiviral, along with Harvoni or Epclusa. Ribavirin has its own side effects to be aware of. So be sure to talk to your prescriber about what to expect if you’re taking Harvoni or Epclusa and ribavirin at the same time.

Are Harvoni and Epclusa hard on your liver?

Not usually. In fact, antiviral medications such as Harvoni and Epclusa actually help lower the risk of liver problems caused by hepatitis C.

In rare cases, Harvoni and Epclusa can reactivate hepatitis B, which can lead to liver problems. People who already have liver scarring (cirrhosis) when they start these medications are also at a higher risk for a rapid decline in liver function (decompensation). But it’s not clear if this is caused by the medication itself or is a response to the drop in hepatitis C virus levels.

Can you take Harvoni and Epclusa at the same time?

No, you shouldn’t take Harvoni and Epclusa at the same time. This could raise your risk of side effects without offering any additional benefits. In most cases, you won’t switch between Harvoni and Epclusa either. If one hepatitis C treatment doesn’t work, a different type of treatment or additional active ingredients are usually recommended for the next round.

How to save on Harvoni and Epclusa

Harvoni and Epclusa are both available brand-name medications. They also both come as a lower-cost generic. GoodRx can help you save over 70% off the cost of generic Harvoni and over 60% off the cost of the generic Epclusa.

If you have commercial insurance, a copay savings program is available for the generic versions as well as the brand-name versions of both Harvoni and Epclusa. A patient assistance program is also available if you’re uninsured or underinsured.

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Written by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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