How Does Harvoni Treat Hepatitis C? Pharmacist-Backed Answers to Harvoni FAQs

Harvoni (ledipasvir / sofosbuvir) is a medication that treats certain types of chronic hepatitis C. Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). It’s a curable condition, thanks to antiviral medications such as Harvoni. But how does Harvoni work to treat hepatitis C?

Here, we’ll cover the answers to this and more common questions about Harvoni.

1. How does Harvoni work for hepatitis C?

Harvoni is a combination of two medications: ledipasvir and sofosbuvir. Both ingredients belong to a drug class called direct-acting antivirals (DAAs).

DAAs work by blocking enzymes (proteins) that the hepatitis C virus needs to make copies of itself. This stops the virus from spreading throughout your body. Over time, since it can’t replicate itself, the amount of virus in your body (viral load) will no longer be detectable. This is known as achieving sustained virologic response (SVR), which is the same as being cured.

There are different types of HCV, known as genotypes 1 through 6. Harvoni is only effective for genotypes 1, 4, 5, and 6. And some people with genotypes 1 or 4 may need to take Harvoni in combination with ribavirin, another antiviral medication.

In clinical studies, 94% to 100% of people were cured (achieved SVR) after 12 weeks of Harvoni treatment.

Disclosure

Harvoni (Ledipasvir/Sofosbuvir)

Avg retail price

$13,196.03(Save 8.26%)

GoodRx discount

$12,105.51

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

2. How long does it take Harvoni to work?

Harvoni starts working soon after you take your first dose. The amount of HCV in your blood usually drops within the first 4 weeks after you start the medication. But you’ll need to take Harvoni for 12 to 24 weeks in order to ensure that it works properly. Stopping Harvoni early increases the chance that your HCV infection will return. 

Your healthcare team will recommend how long to take Harvoni based on your genotype. They’ll also take into account whether you have cirrhosis (scarring of the liver), how well your liver is working, and other factors.  

3. Does Harvoni cause weight gain?

Weight gain isn’t a common Harvoni side effect during clinical studies. But some evidence suggests that weight gain may occur after hepatitis C is treated with DAAs including Harvoni.

One study of over 11,000 adults treated for hepatitis C with DAAs found that more than half of the participants gained weight in the 2 years after treatment. There are several possible reasons:

• Hepatitis C can cause fatigue and low appetite. So after it’s treated, you may feel better and have an increased appetite, which can lead to weight gain.

• Hepatitis C can reduce muscle mass. Once it’s treated, your muscle mass may increase, leading to weight gain.

• The chronic inflammation caused by hepatitis C may trigger your body to use extra energy to try to manage it. Once the inflammation is gone, your body doesn’t need to burn that energy any more, which may lead to weight gain.  

The risk of weight gain seems to be higher after hepatitis C treatment if you consume alcohol, are under the age of 65, or have liver cirrhosis. But there are steps you can take to help prevent weight gain after Harvoni treatment. Good first steps are to exercise regularly, follow a nutritious diet, and avoid alcohol. Meeting with a nutritionist can also be helpful. Let your healthcare team know if you have concerns about weight changes after taking Harvoni.

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.

• Do you need to treat hepatitis C? Yes. Untreated hepatitis C can lead to serious health risks. Read more here.

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

4. Can you drink alcohol while taking Harvoni?

In the past, experts recommended that people avoid alcohol for at least 6 months before starting HCV treatment. That’s because older treatments, such as interferon, were less effective in people who consumed alcohol. But alcohol doesn’t seem to affect how well DAAs work to treat hepatitis C. So you can (and should) still receive treatment if you drink alcohol.

That being said, it’s best to avoid alcohol if you’re being treated for hepatitis C. Alcohol can raise your risk of liver damage, cirrhosis, and liver cancer if you’re living with hepatitis C. Keep in mind that the liver damage caused by hepatitis C can linger long after treatment is finished. So it’s a good idea to continue to limit or avoid alcohol even after you no longer have hepatitis C. 

Talk to a healthcare professional if you have concerns about your ability to limit or stop drinking while taking Harvoni and after treatment. They can help provide support to set you up for success.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.

5. Can hepatitis C come back after Harvoni treatment?

Hepatitis C is unlikely to come back if you’ve reached SVR after taking Harvoni. But if you stop taking Harvoni sooner than recommended, your infection can become active again. And in rare cases, you may not respond well to Harvoni. Your prescriber will monitor the levels of virus in your system and take steps if either of these issues occurs. Be sure to keep your appointments and take Harvoni as directed. 

That being said, Harvoni treatment doesn’t make you immune to hepatitis C or protect you from getting it again in the future. It’s important to take steps to avoid reinfection after completing treatment.

Hepatitis C is passed through blood that contains the virus. The following tips can help reduce your risk of exposure:

• Don’t share needles or razors.

• Always wear gloves if you clean up someone else’s blood or provide first aid.

• If you get tattoos or piercings, make sure that the artist uses clean equipment and sterilization techniques.

• Use condoms or other barrier methods to help prevent blood contact that could occur during sex. 

6. Who should not take Harvoni?

Harvoni is only effective for hepatitis C caused by certain genotypes of HCV. It isn’t recommended for those with genotypes 2 or 3. 

Taking Harvoni can worsen or reactivate a hepatitis B infection. Your prescriber will test for hepatitis B before you start taking Harvoni and take steps to manage it, if needed.

It isn’t recommended to take Harvoni with amiodarone (Pacerone), a medication that helps regulate your heart rhythm. If the combination can’t be avoided, your healthcare team will keep a close eye on your heart rate. This may require a hospital stay for the first couple of days you’re taking the medications together.

Harvoni has several other drug interactions that could cause an issue for you. Review your complete medication list with your healthcare team before you start taking it.

How to save on Harvoni

There are ways to save on Harvoni, which is available as both a brand-name and generic medication. GoodRx can help you save over 70% off the average retail price of the generic version. And a savings program is available for brand-name Harvoni, regardless of your insurance status.

Why trust our experts?

Written by:

Patricia Weiser, PharmD

Patricia Weiser, PharmD, 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. Ulrich’s experience includes direct patient care in hospital and community pharmacies.

Our editorial standards

Meet our experts