Harvoni vs. Mavyret for Hepatitis C: 6 Things to Be Aware Of

Hepatitis C is a viral infection that affects the liver. Without treatment, it can cause serious health problems. But the good news is that there are several highly effective treatments available that can cure hepatitis C.

Harvoni (ledipasvir / sofosbuvir) and Mavyret (glecaprevir / pibrentasvir) are two first-choice options, but they aren’t exactly the same. Here’s what you should know about Harvoni versus Mavyret for hepatitis C.

1. Harvoni and Mavyret contain different medications

Both Harvoni and Mavyret belong to a class of medications called direct-acting antivirals (DAAs). They work by blocking certain enzymes (proteins) the hepatitis C virus needs in order to make copies of itself. Over time, these medications lower the amount of hepatitis C in your body. Once it becomes undetectable, known as a sustained virologic response, you’re considered cured.

While they work the same way, Harvoni and Mavyret contain different active ingredients. Harvoni contains ledipasvir and sofosbuvir. Mavyret, on the other hand, combines glecaprevir and pibrentasvir. Each ingredient in Harvoni and Mavyret targets a different hepatitis C enzyme. This means that the two medications treat different types of the hepatitis C virus — more on that next. 

2. Mavyret treats more types of hepatitis C than Harvoni

One of the main differences between Harvoni and Mavyret is the types of hepatitis C they treat.

There are six different types of the hepatitis C virus, numbered 1 through 6. Harvoni only works against types 1, 4, 5, and 6. In contrast, Mavyret is effective for all six types of hepatitis C. Because of this, Mavyret is considered a first-choice option over Harvoni if you’re treating hepatitis C for the first time.

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.

Harvoni and Mavyret are both considered highly effective at treating hepatitis C. They haven’t been directly compared in clinical studies. But Harvoni was reported as ineffective more often than Mavyret in the FDA’s Adverse Events Reporting System. Keep in mind that this doesn’t take other factors into account, such as whether the medication was taken correctly. Your prescriber will choose the best medication for you based on your medical history and treatment needs.

3. Harvoni and Mavyret have different dosages and treatment lengths

Both Harvoni and Mavyret are approved to treat hepatitis C in adults and children age 3 and older. Both medications are taken once a day. And they both come in oral tablets as well as pellets that can be mixed with soft food. The pellets may be a better option for young children or adults who have trouble swallowing pills. You can take Harvoni with or without food. But you should take Mavyret with food. 

The available doses of both medications are shown in the chart below. Since Harvoni comes in more doses, you’ll typically only need to take 1 or 2 tablets (or pellet packets) per day. Mavyret, on the other hand, usually requires 3 tablets or 3 to 5 packets of pellets per day.

There are also differences in how long you’ll take Harvoni versus Mavyret. In most cases, you’ll take Harvoni for 12 weeks. But treatment can range from 8 to 24 weeks (2 to 6 months). A course of Mavyret can take between 8 and 16 weeks, depending on what type of hepatitis C you’re treating.

4. You can take Harvoni if you have liver problems, but Mavyret may not be an option

Mavyret has more restrictions on who can take it, particularly when it comes to liver disease.

Mavyret is only a treatment option when you have either no liver scarring (cirrhosis) or mild scarring that isn’t causing symptoms (known as compensated cirrhosis). It isn’t an option for those with moderate-to-severe liver problems, because it could make the condition worse.

Harvoni, on the other hand, can be used whether or not cirrhosis is present. But in some cases, you’ll need to take another medication, ribavirin, along with it.

5. Harvoni and Mavyret have similar side effects

Fatigue, headache, and nausea are the most common side effects of both Harvoni and Mavyret. Most people tolerate these medications well, and the side effects are usually mild.

More serious side effects are rare but possible. For instance, both medications carry a boxed warning about the risk of reactivating hepatitis B during treatment. This is the FDA’s most serious type of medication warning. To help prevent this, your prescriber will test you for hepatitis B before starting treatment with either medication. As mentioned, Mavyret may also cause or worsen liver problems, especially if advanced liver problems were present before starting the medication.

6. Harvoni and Mavyret have different drug interactions to consider

Harvoni and Mavyret both have a number of drug interactions to consider. But there are some differences between them.

Harvoni and Mavyret both interact the following medications:

• Digoxin

• Carbamazepine

• Phenytoin

• Rifampin

• Certain statins

• Certain HIV antiviral medications

• St. John’s wort

Drug interactions specific to Harvoni include:

• Antacids

• Histamine-2 blockers

• Proton pump inhibitors

• Amiodarone

Drug interactions specific to Mavyret include:

• Dabigatran

• Cyclosporine

• Hormonal therapy that contains more than 20 mcg of ethinyl estradiol

Keep in mind that this isn’t a complete list of all possible interactions with these medications. Review your medication list with your prescriber before starting hepatitis C treatment. Be sure to include any over-the-counter medications or supplements you’re taking. They can help you avoid or manage drug interactions.

Can you take Harvoni and Mavyret at the same time?

No, you shouldn’t take Harvoni and Mavyret at the same time. There’s no added benefit of combining different DAA treatments. But taking both could raise your risk of side effects.

And in most cases, you won’t switch from Harvoni to Mavyret or vice versa. If one hepatitis C treatment doesn’t work, a different type of treatment or additional ingredient is recommended for the second attempt. 

How to save on Harvoni and Mavyret

Harvoni and Mavyret are both available brand-name medications. But Harvoni also comes as a lower-cost generic. Both medications can be very costly without insurance coverage. But GoodRx can help you navigate ways to save on your prescription.

• Save with GoodRx. GoodRx can help you save over 70% off the average retail price of the generic version of Harvoni.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Mavyret’s price is as low as $5 per month with a savings card from the manufacturer. A copay savings program is also available for both generic and brand-name Harvoni.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Harvoni or Mavyret’s patient assistance programs, which offer the medication at no charge.

Why trust our experts?

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:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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