Sofomax

Indications

Sofosbuvir is used to treat long-term (chronic) hepatitis C virus infection in adults. It is always taken together with other hepatitis C medicines, such as Velpatasvir, Ledipasvir or Daclatasvir, and sometimes Ribavirin. The doctor chooses the combination and the length of treatment based on the virus type (genotype) and the condition of the liver.

How It Works

The hepatitis C virus needs an enzyme called NS5B polymerase to copy itself. Sofosbuvir blocks this enzyme, so the virus cannot multiply. Used in the right combination, it can clear the virus from the body in most people.

Dosage and Administration

• Adults: 400 mg once a day by mouth, with or without food, always with another hepatitis C medicine. Treatment usually lasts 12 weeks, but may be 8 to 24 weeks, as prescribed.
• Children: only as prescribed by a specialist.
• Take it at the same time every day and finish the full course. Do not take Sofosbuvir on its own.
• If a dose is missed, take it the same day as soon as you remember. Do not take two doses at once.

Interactions

• Amiodarone: can cause a dangerously slow heartbeat when taken with Sofosbuvir combinations. Avoid unless a heart specialist decides otherwise.
• Rifampicin, Rifabutin, Carbamazepine, Phenytoin, Phenobarbital, Oxcarbazepine and St John's wort lower Sofosbuvir levels and can make treatment fail. Do not combine.
• Antacids and stomach acid medicines (such as Omeprazole or Famotidine) can lower the absorption of the partner medicine (Velpatasvir or Ledipasvir). Ask the doctor how to space them.
• Tell the doctor about every medicine you take, including herbal products.

Contraindications

Allergy to sofosbuvir or any ingredient of the product. It must not be used in any situation where its partner medicine is not allowed, for example with Ribavirin during pregnancy.

Side Effects

Common: tiredness, headache, nausea, trouble sleeping and irritability. When combined with Ribavirin, anaemia (low blood count) is also common.

Get urgent medical help for: a very slow heartbeat, fainting, chest pain or shortness of breath (especially if you also take Amiodarone); yellow eyes or skin, dark urine, confusion or swelling of the tummy; or signs of a serious allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

There is little information on Sofosbuvir alone in pregnancy, so it is used only if the doctor decides it is needed. If the treatment includes Ribavirin, pregnancy must be avoided by women and by female partners of men taking it, during treatment and for 6 months after. Breastfeeding is not recommended during treatment unless the doctor advises otherwise.

Precautions and Warnings

• A hepatitis B test is needed before starting, because hepatitis B can flare up during or after hepatitis C treatment.
• People with diabetes may need closer sugar checks, as blood sugar can drop when hepatitis C clears.
• People with severe kidney disease or advanced liver disease need specialist care.
• Do not stop early, even if you feel well, and attend all blood tests.

Overdose

There is no specific antidote. If too much is taken, seek medical help straight away. Treatment is supportive and the heart is monitored.

Therapeutic Class

Antiviral for hepatitis C (NS5B polymerase inhibitor).

Storage

Store below 30°C in a dry place, in the original pack, away from light and out of the reach of children.