sofosbuvir / velpatasvir
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.
What is Epclusa (sofosbuvir / velpatasvir)?
What is Epclusa (sofosbuvir / velpatasvir) used for?
- Chronic hepatitis C infection
How Epclusa (sofosbuvir / velpatasvir) works
Epclusa (sofosbuvir / velpatasvir) contains 2 antiviral medications that work together to stop the hepatitis C virus from making copies of itself in the body.
Drug facts
Side effects of Epclusa (sofosbuvir / velpatasvir)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache
- Fatigue
Less Common Side Effects
- Skin rash
- Nausea
- Weakness
- Difficulty sleeping
- Diarrhea
More on Epclusa (sofosbuvir / velpatasvir) side effects
The following Epclusa (sofosbuvir / velpatasvir) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Diarrhea
- Fatigue
- Headache
- Nausea
- Trouble sleeping
- Worsening mood, feelings of depression
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Pros and cons of Epclusa (sofosbuvir / velpatasvir)
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
Pharmacist tips for Epclusa (sofosbuvir / velpatasvir)
- Let your provider know if you have ever been treated for hepatitis B or C in the past. Your provider might change your medication treatment and lab monitoring based on your treatment history.
- Make sure you take your prescribed dose every day at the same time with or without food. Continue to take the medication until your provider instructs you to stop.
- If you happen to be hospitalized during your course of hepatitis C treatment, make sure you bring your antiviral medications with you to the hospital. Most hospitals do not have hepatitis C medications in stock because they are expensive. They have procedures in place to administer your home medications so that your treatment will not be interrupted.
- Tell your hepatitis C provider about all the medications you are taking. Epclusa (sofosbuvir / velpatasvir) interacts with a lot of common medications like famotidine (Pepcid AC), omeprazole (Prilosec), and cholesterol-lowering statins. The interacting medications might need their dose lowered or scheduled around your Epclusa (sofosbuvir / velpatasvir) dose.
Common questions about Epclusa (sofosbuvir / velpatasvir)
Yes, a successful treatment with Epclusa (sofosbuvir / velpatasvir) is considered a cure for hepatitis C when there are no detectable hepatitis C viruses found in the body. In clinical trials, Epclusa (sofosbuvir / velpatasvir) had very successful cure rates of up to 100% for hepatitis C.
It's not likely that hepatitis C will come back after successful treatment with Epclusa (sofosbuvir / velpatasvir). However, treatment of hepatitis C doesn't make you immune to the virus, so it's possible to become reinfected. After treatment, it's important to continue to protect yourself from hepatitis C and not share things like razors and needles.
Avoid alcohol while taking Epclusa (sofosbuvir / velpatasvir). It's not known if alcohol interacts with the medication, but alcohol and hepatitis C can both damage the liver.
Both antiviral medications are very good at curing hepatitis C. The biggest difference is that Epclusa (sofosbuvir / velpatasvir) works for all types of hepatitis C, while Harvoni works for 4 out of 6 types.
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Risks and warnings for Epclusa (sofosbuvir / velpatasvir)
Epclusa (sofosbuvir / velpatasvir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Hepatitis B reactivation
- Risk factors: History of hepatitis B infection
Some people who have both hepatitis B and C have had their hepatitis B reactivated or flare up after starting treatment for hepatitis C. This can cause liver problems and even death if not caught early and treated. You should get tested for hepatitis B before you start Epclusa (sofosbuvir / velpatasvir). Tell your provider if you've ever had hepatitis B or been treated for it in the past.
Slow heart rate
- Risk factors: Also taking amiodarone | Also taking beta blockers | History of heart disease | History of advanced liver disease
There have been cases of slow heart rate and fatal heart problems when people take amiodarone and Epclusa (sofosbuvir / velpatasvir) together. It usually happens right after Epclusa (sofosbuvir / velpatasvir) is started, but can also happen weeks after the combination is taken. It's also more likely to happen in people taking beta blockers or those with advanced liver disease or underlying heart disease. Tell your provider if you are taking or have recently taken amiodarone. They may choose a different hepatitis C medication for you, or closely monitor your heart rate. Go to the emergency room right away if you take these medications together and feel faint, dizzy, weak, or have trouble breathing.
Ribavirin risks
- Risk factors: Taking ribavirin with Epclusa (sofosbuvir / velpatasvir)
People with certain types of liver problems may need to take an antiviral medication called ribavirin in addition to Epclusa (sofosbuvir / velpatasvir). Ribavirin can have a lot of side effects, so make sure to review this medication with your provider and pharmacist before starting your hepatitis C treatment.
Interactions with other medications
Epclusa (sofosbuvir / velpatasvir) interacts with many medications and a few herbal supplements. Medications such as rifampin (Rifadin), carbamazepine (Tegretol), and herbal supplements like St. John's wort can lower the amount of Epclusa (sofosbuvir / velpatasvir) in your body which can make the medication not work as well. It's important to let your provider and pharmacist know all the medications you're currently taking, including vitamins, herbal supplements, and over-the-counter (OTC) medications.
Epclusa (sofosbuvir / velpatasvir) dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 400mg/100mg | 1 dose pack | $7,766.04 | $7,766.04 |
Typical dosage for Epclusa (sofosbuvir / velpatasvir)
Adults: The recommended dose is 1 tablet (400 mg of sofosbuvir and 100 mg of velpatasvir) by mouth once a day.
Children age 3 or older: The dose is based on your child's weight
- Less than 17 kg: one 150 mg/37.5 mg (sofosbuvir/velpatasvir) packet of pellets by mouth once a day.
- 17 to 30 kg: one 200 mg/50 mg (sofosbuvir/velpatasvir) packet of pellets by mouth once a day.
- 30 kg and more: two 200 mg/50 mg (sofosbuvir/velpatasvir) packet of pellets by mouth once a day.
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