Sovaldi

sofosbuvir

Used for Hepatitis C

Sovaldi (sofosbuvir) is an expensive antiviral medication used with other antiviral medications to treat chronic hepatitis C infection.

Reviewed by:

Hope Chang, PharmD, AAHIVP

Michelle Nguyen, PharmD

Last reviewed on May 31, 2021

What is Sovaldi (sofosbuvir)?

What is Sovaldi (sofosbuvir) used for?

Hepatitis C infection genotype 1, 2, 3, 4

How Sovaldi (sofosbuvir) works

Sovaldi (sofosbuvir) is a direct-acting antiviral medication. It stops an enzyme that the hepatitis C virus (HCV) needs for replication. Without the enzyme, HCV can't make more viruses in your body.

Drug facts

Common Brands	Sovaldi
Drug Class	Antiviral
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Sovaldi

Drug Class

Antiviral

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

Side effects of Sovaldi (sofosbuvir)

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

Since Sovaldi (sofosbuvir) is always taken with other medications it is difficult to know what side effects this specific medication causes. Many of these side effects may be caused by other hepatitis C medications, such as ribavirin and peginterferon.

Fatigue, tireness (38%)
Headache (24%)
Nausea (22%)
Trouble sleeping, insomnia (15%)
Itchy skin (11%)
Anemia/low blood count (10%)
Irritability (10%)
Rash (8%)

Less Common Side Effects

Low appetite
Muscle pain
Weakness
Cold and flu symptoms
Chills

Source: FDA

The following Sovaldi (sofosbuvir) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Chills

fever

lower back or side pain

pale skin

ulcers, sores, or white spots in the mouth

unusual tiredness or weakness

Rare

Changes in behavior

discouragement

feeling sad or empty

loss of interest or pleasure

thoughts of killing oneself

trouble concentrating

Incidence not known

Chest pain or discomfort

lightheadedness, dizziness, or fainting

shortness of breath

slow or irregular heartbeat

unusual tiredness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Decreased appetite

diarrhea

difficulty with moving

headache

irritability

lack or loss of strength

muscle aching or cramping

muscle pains or stiffness

nausea

rash or itching skin

trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See more Sovaldi (sofosbuvir) side effects

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Avg retail price

N/A

$966.25

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Pros and cons of Sovaldi (sofosbuvir)

Pros

Only taken once a day
Successful treatment means a cure of hepatitis C
Can be used in children age 3 years and older
Fewer side effects than other hepatitis C medications, like ribavirin and interferon
Available in antiviral combination medications

Cons

Can be very expensive
Must be used in combination with other antiviral medications
Not a good option for people taking amiodarone because the combination can cause serious drops in heart rate
Doesn't treat all 6 types of hepatitis C
Some people who have hepatitis B and C have had their hepatitis B come back after taking hepatitis C treatment

Pharmacist tips for Sovaldi (sofosbuvir)

Take Sovaldi (sofosbuvir) around the same time each day to keep the medication levels in your body consistent. It can be taken with or without food.
Get your labs drawn when your provider instructs you to. This is how they will monitor your liver and make sure the medication is working against the virus. An important lab called "SVR" will be drawn 12 weeks after you have stopped the medication. The results of this lab will determine if you have been cured of hepatitic C.
Sovaldi (sofosbuvir) can interact with other medications. Tell your provider all the medications you are taking so they can check for iteractions. Do not take the herbal supplement St. John's wort while you taking medications for hepatitis C.
Sovaldi (sofosbuvir) needs to be taken with other antiviral medications for the treatment of hepatitis C. If your provider instructs you to stop your HCV treatment, all the antivirals should be stopped at the same time so the virus doesn't become resistant to any of the medications. Make sure you clarify all medication questions with your providers before starting or stopping any medications.
Do not chew the oral pellets. They can either be taken directly from the packet or sprinkled on non-acidic soft food. Non-acidic soft foods include: pudding, chocolate syrup, mashed potatoes, and ice cream.

Common questions about Sovaldi

Yes, a successful treatment with antiviral medications is considered a cure for heptitis C.

It's not likely that heptitis C will come back after achieving "SVR," which is considered a cure. 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 receive unclean tattoos or share things like razors and needles.

Avoid alcohol while taking Sovaldi. It's not known if alcohol interacts with the medication, but alcohol and hepatitis C can both damage the liver.

There are a few possible explanations for the high price tag of Sovaldi. As a medication class, many of the hepatitis C antivirals have high cure rates and are usually very expensive. Sovaldi is currently only available as a brand name medication, which are typically more expensive than generic medications. Even though Sovaldi is brand name only on it's own, it is actually available in generic antiviral combinations such as Epclusa and Harvoni.

Sovaldi is an antiviral medication used for the treatment of chronic hepatitis C. It will not work for any other type of bacterial or viral infection.

Risks and warnings for Sovaldi (sofosbuvir)

Sovaldi (sofosbuvir) 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

Black Box Warning Some people who have both hepatitis B and C have had their hepatitis B reactivate or flare up after starting treatment for hepatitic C. This can cause liver problems if not caught and treated. You should be tested for hepatitis B before you start Sovaldi (sofosbuvir). Tell your provider if you've ever had hepatitis B or been treated for it in the past.

SLOW HEART RATE

Risk factors: Amiodarone | Beta blockers | Heart disease | Liver disease

There have been cases of slow heartbeat and fatal heart problems when people take amiodarone (Pacerone) and Sovaldi (sofosbuvir). It usually happens right after Sovaldi (sofosbuvir) is started, but can also happen weeks after the combination is taken. It's more likely to happen in people also taking beta blockers or with severe liver problems. Tell your provider if you are taking or have recently taken amiodarone. They may choose a different hepatitic C medication for you, or closely monitor your heartbeat. 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 Sovaldi (sofosbuvir)

In addition to Sovaldi (sofosbuvir), many people may need to take an antiviral medication called ribavirin. Ribavirin can have a lot of side effects and should not be taken during pregnancy. Make sure to review this medication with your provider and pharmacist before starting your hepatitis C treatment.

Sovaldi (sofosbuvir) dosage

The average cost for 28 tablets of 400mg of Sovaldi (sofosbuvir) is $26,886.25 with a free GoodRx coupon. This is 20.00% off the average retail price of $33,606.79.

Carton

Dosage	Quantity	Price as low as	Price per unit
28 packets of oral pellets of 150mg	28 cartons	$26,886.25	$960.22
28 packets of oral pellets of 200mg	1 carton	$966.25	$966.25

Tablet

Dosage	Quantity	Price as low as	Price per unit
400mg	28 tablets	$26,886.25	$960.22
200mg	30 tablets	$28,806.25	$960.21

See more Sovaldi (sofosbuvir) dosage

Interactions between Sovaldi (sofosbuvir) and other drugs

Sovaldi (sofosbuvir) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sovaldi (sofosbuvir). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Rifampin

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.