Drug Action
Sofosbuvir is a nucleotide analogue inhibitor and velpatasvir is an HCV inhibitor; they reduce viral load by inhibiting hepatitis C virus RNA replication.
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Drug reference
Sofosbuvir is a nucleotide analogue inhibitor and velpatasvir is an HCV inhibitor; they reduce viral load by inhibiting hepatitis C virus RNA replication.
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Chronic hepatitis C infection, with or without ribavirin (initiated by a specialist) ▶BY MOUTH ▶Adult: 400/100 mg once daily for 12 weeks (may extend to 24 weeks in some circumstances—consult product literature)
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DUE TO INTERACTIONS ▶Manufacturer advises reduce dose of concurrent H2- receptor antagonist if above a dose comparable to famotidine 40 mg twice daily. ▶Manufacturer advises reduce dose of concurrent proton pump inhibitor if above a dose comparable to omeprazole 20 mg; take 4 hours after sofosbuvir with velpatasvir. DOSE EQUIVALENCE AND CONVERSION ▶Dose expressed as x/y mg sofosbuvir/velpatasvir.
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Hepatitis B co-infection
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NICE decisions ▶Sofosbuvir–velpatasvir for treating chronic hepatitis C (January 2017) NICE TA430 Sofosbuvir with velpatasvir is recommended as an option for treating chronic hepatitis C infection in adults, if the following criteria are met: . of genotype 1, 3, 4, 5 or 6 with or without cirrhosis (previously treated or treatment naive patients); . of genotype 2 with cirrhosis (previously treated or treatment naive patients); . of genotype 2 without cirrhosis (treatment naive patients), only if interferon not suitable or not tolerated, or without cirrhosis (previously treated patients). This is contingent on the manufacturer providing the drug with the discount agreed in the simple discount agreement. Patients whose treatment was started within the NHS before this guidance was published, should continue treatment until they and their clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta430 Scottish Medicines Consortium (SMC) decisions SMC No. 1195/16 The Scottish Medicines Consortium has advised (November 2016) that sofosbuvir with velpatasvir (Epclusa ®) is accepted for restricted use within NHS Scotland for the treatment of adults with chronic hepatitis C infection of genotype 3 only. SMC No. 1271/17 The Scottish Medicines Consortium has advised (October 2017) that sofosbuvir with velpatasvir (Epclusa ®) is accepted for restricted use within NHS Scotland for the treatment of chronic hepatitis C virus (HCV) infection in adults with genotype 2, 5 or 6 or decompensated cirrhosis, irrespective of chronic HCV genotype. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower. SMC No. 1271/17 The Scottish Medicines Consortium has advised (April 2018) that sofosbuvir with velpatasvir (Epclusa ®) is accepted for restricted use within NHS Scotland for the treatment of chronic hepatitis C virus (HCV) infection in adults with genotype 1 or 4. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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→Appendix 1: sofosbuvir. velpatasvir
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Atrioventricular block. bradycardia. fatigue . headache. nausea
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 25 ▶Epclusa (Gilead Sciences International Ltd) A Velpatasvir 100 mg, Sofosbuvir 400 mg Epclusa 400mg/100mg tablets | 28 tablet P £12,993.33
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Vomiting Manufacturer advises if vomiting occurs within 3 hours of administration, an additional dose should be taken.
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400/100 mg once daily for 12 weeks (may extend
First-line fragment. Read the complete Indications and Dose section above.
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