Epclusa sofosbuvir/velpatasvir

Sofosbuvir-velpatasvir tablets are a compound antiviral drug mainly used to treat chronic hepatitis C virus (HCV) infection in adults. Its core ingredients are sofosbuvir (400 mg/tablet) and velpatasvir (100 mg/tablet). It works by inhibiting viral replication and is suitable for patients with all HCV genotypes. It also provides differentiated treatment options for different liver disease stages (such as cirrhosis).

1. Indications and Mechanisms of Action
Indications: Adult chronic hepatitis C (including patients with no cirrhosis, compensated or decompensated cirrhosis).
Mechanism: Sofosbuvir inhibits HCV’s NS5B polymerase, and velpatasvir targets the NS5A protein, doubly blocking viral replication.
2. Usage and Dosage
Usual dose: 1 tablet per day, taken with meals or on an empty stomach, swallowed whole (do not chew).
‌Adjustments for special populations‌:
‌No cirrhosis or compensated cirrhosis‌: Single-drug treatment for 12 weeks; patients with genotype 3 compensated cirrhosis can be treated with ribavirin.
‌Decompensated cirrhosis‌: Ribavirin is required for 12 weeks, and the dose is adjusted according to body weight (<75kg: 1000mg/day; ≥75kg: 1200mg/day). ‌Missed dose treatment‌: Missed doses should be taken within 18 hours, and skipped if missed for more than 18 hours to avoid double doses. 3. Precautions ‌Risk of HBV reactivation‌: Screening for hepatitis B is required before treatment, and signs of HBV reactivation should be monitored during treatment. ‌Drug interactions‌: ‌Contraindications‌: Combination with strong P-gp/CYP inducers (such as rifampicin, St. John's wort) may reduce efficacy. ‌Use with caution‌: Combination with amiodarone may cause severe bradycardia and requires close monitoring. ‌Special population‌: ‌Pregnant women and lactating women: Not recommended for use, lack of safety data. ‌Abnormal liver and kidney function‌: Mild to moderate damage does not require dose adjustment; severe renal insufficiency requires caution. 4. Adverse reactions ‌Common reactions‌ (≥10%): Headache, fatigue, nausea. ‌Severe reactions‌ (rare): Rash, angioedema, arrhythmia. ‌Patients with decompensated cirrhosis‌: Anemia may occur due to the combination of ribavirin, and hemoglobin needs to be monitored. 5. Contraindications It is contraindicated for those who are allergic to the drug ingredients. It is prohibited to use it in combination with specific strong inducers (such as carbamazepine and phenytoin). 6. Drug interactions and combined use recommendations ‌Antacids/H2 receptor antagonists‌: Take it 4 hours apart. ‌Proton pump inhibitors‌ (such as omeprazole): Avoid combined use, and use it 4 hours before taking the medicine if necessary. ‌HIV antiviral drugs‌: Combination with tenofovir disoproxil fumarate may increase the risk of nephrotoxicity, and renal function needs to be monitored. ‌Summary‌: Sofosbuvir and velpatasvir tablets are broad-spectrum anti-HCV drugs with significant efficacy, but the regimen needs to be adjusted according to the stage of liver disease, genotype, and concomitant medication. During treatment, drug interactions and adverse reactions need to be closely monitored, and the doctor's instructions must be strictly followed to ensure safety and efficacy.