Indications
Velpatasvir is an antiviral medicine for chronic hepatitis C virus infection in adults (and in some children as decided by a specialist). It is used in a fixed combination with Sofosbuvir, and works against all six main hepatitis C genotypes. It may be given with Ribavirin in people with advanced liver cirrhosis.
How It Works
Velpatasvir blocks NS5A, a protein the hepatitis C virus needs to copy itself and assemble new virus particles. Sofosbuvir blocks a different viral enzyme (NS5B polymerase). Together they stop the virus from multiplying, and in most people the virus is cleared from the blood, curing the infection.
Dosage and Administration
The usual adult dose is one tablet containing Sofosbuvir 400 mg and Velpatasvir 100 mg once a day by mouth, with or without food, for 12 weeks, or as prescribed by a specialist. Take it at the same time each day and complete the full course. If you vomit within 3 hours of a dose, take another tablet.
Interactions
- Amiodarone with Sofosbuvir based treatment can cause a dangerously slow heartbeat; this combination should be avoided.
- Antacids, H2 blockers (such as Famotidine) and proton pump inhibitors (such as Omeprazole) reduce absorption; follow your doctor’s advice on timing, or avoid them.
- Rifampicin, Carbamazepine, Phenytoin, Phenobarbital and St John’s Wort must not be used with it, as they stop it working.
- Efavirenz and some other HIV medicines are not recommended with it.
- It may raise levels of Digoxin, Rosuvastatin and Atorvastatin.
Contraindications
- Allergy to Velpatasvir or Sofosbuvir.
- Use with strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin or St John’s Wort.
Side Effects
Common side effects include headache, tiredness, nausea, trouble sleeping and weakness. If Ribavirin is also taken, anaemia is common. People who also carry hepatitis B may have a flare of hepatitis B during or after treatment. In people with diabetes, blood sugar may fall as the liver improves.
Get urgent medical help if you have a very slow heartbeat, fainting, chest pain or breathlessness, yellowing of the skin or eyes, dark urine, severe tiredness, or signs of a serious allergic reaction.
Pregnancy and Lactation
There is limited information on use in pregnancy; it should be used only if a doctor decides it is necessary. If Ribavirin is part of the treatment, pregnancy must be strictly avoided by both female patients and female partners of male patients during and for months after treatment. Breastfeeding is not recommended during treatment.
Precautions and Warnings
- You will be tested for hepatitis B before starting.
- Check blood sugar more often if you have diabetes.
- Tell your doctor about all medicines, including acid reducing medicines and herbal products.
- Cure does not prevent reinfection; avoid sharing needles, razors and toothbrushes.
Overdose
There is limited experience of overdose. If too much is taken, contact a doctor or hospital. Treatment is supportive with monitoring.
Therapeutic Class
Direct acting antiviral for hepatitis C; NS5A inhibitor (used with Sofosbuvir).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.