Epclusa

Epclusa is the brand name for the fixed-dose combination of sofosbuvir and velpatasvir, an oral antiviral medication manufactured by Gilead Sciences. It is used to treat chronic hepatitis C virus (HCV) infection and is notable for its pangenotypic activity, meaning it is active against all major HCV genotypes (1–6). Sofosbuvir is a nucleotide polymerase inhibitor targeting NS5B, while velpatasvir inhibits the NS5A replication complex; together they block viral replication and assembly.

Epclusa is indicated for adults and certain pediatric patients with chronic HCV infection, including individuals with compensated cirrhosis. The standard regimen is one 400 mg/100 mg tablet taken once daily for 12 weeks; in some clinical situations, an 8-week course or a longer treatment duration may be recommended depending on genotype, cirrhosis status, prior treatment, and other factors, in line with current guidelines.

The medication can be taken with or without food. It is generally well tolerated; common adverse effects include headache and fatigue. Serious adverse events are uncommon but may occur, and Epclusa can interact with other drugs, particularly strong inducers or inhibitors of hepatic enzymes and transporters, anticonvulsants, rifampin, and St. John’s wort. Coadministration with certain acid-reducing agents may alter velpatasvir exposure, requiring clinical management. As with all hepatitis C therapies, Epclusa should be prescribed by clinicians experienced in treating HCV, and patients should be monitored for response and potential drug interactions.