Sofosbuvirvelpatasvir

Sofosbuvirvelpatasvir, commonly written sofosbuvir/velpatasvir, is a fixed-dose oral antiviral drug used to treat chronic hepatitis C virus (HCV) infection. It is sold under the brand name Epclusa and is approved for adults and for certain pediatric patients.

Mechanism and spectrum: The combination pairs sofosbuvir, a nucleotide NS5B polymerase inhibitor, with velpatasvir, an NS5A inhibitor. Together they block multiple steps of the HCV replication cycle and provide pan-genotypic activity against genotypes 1 through 6. The usual tablet contains sofosbuvir 400 mg and velpatasvir 100 mg, taken once daily with or without food.

Indications and regimen: Sofosbuvir/velpatasvir is indicated for chronic HCV infection in adults and in eligible pediatric patients, including those with or without compensated cirrhosis. The typical course is 12 weeks; in certain subgroups or clinical situations, longer treatment or the addition of ribavirin may be considered according to guidelines.

Safety and interactions: Common adverse effects include fatigue, headache, and nausea. Clinically important drug interactions can occur with strong inducers or inhibitors of drug-metabolizing enzymes and transporters. Velpatasvir absorption can be affected by proton pump inhibitors; amiodarone can raise the risk of bradycardia when used with sofosbuvir-containing regimens. The regimen is not recommended for use in patients with decompensated cirrhosis and should be used with caution in individuals with severe renal impairment.

Regulatory status and use: SoF/Velpatasvir was approved for hepatitis C treatment in 2016 and has since become a widely used pan-genotypic option in both adult and eligible pediatric populations.