SOFOSVEL (SOFOSBUVIR 400MG + VELPATASVIR 100MG) TABLETS 28`S

Sofosvel is a once-daily, all-oral, pan-genotypic (effective against all HCV genotypes 1–6) treatment for chronic hepatitis C virus (HCV) infection in adults and children aged 6 years and older (weighing at least 17 kg). It combines two different antiviral mechanisms:

•       Sofosbuvir: an NS5B RNA polymerase inhibitor — blocks the enzyme HCV uses to copy its genetic material.

•       Velpatasvir: an NS5A protein inhibitor — blocks a protein essential for HCV replication and assembly.

This dual mechanism, targeting two different points in the viral lifecycle, makes it highly effective with very low rates of resistance development. A 12-week course achieves sustained virological response (SVR — 'cure') rates exceeding 95% in most patient groups.

It is used for: all HCV genotypes (1–6); compensated and decompensated liver cirrhosis (with or without ribavirin); and treatment-naive or treatment-experienced patients.

One tablet (sofosbuvir 400 mg + velpatasvir 100 mg) taken once daily with or without food. Treatment duration is 12 weeks for most patients. Patients with decompensated cirrhosis receive sofosbuvir/velpatasvir plus ribavirin for 12 weeks. Swallow the tablet whole — do not crush or chew.

Sofosvel should not be used: with rifampicin, rifabutin, carbamazepine, phenytoin, phenobarbital, or St John's Wort (potent P-gp/CYP inducers — reduce levels to sub-therapeutic); with amiodarone (bradycardia risk); in known hypersensitivity to sofosbuvir, velpatasvir or excipients.

Use with caution in severe renal impairment (eGFR <30 mL/min/1.73 m2) — accumulation of inactive sofosbuvir metabolite; specialist guidance required.

•       Potent P-gp/CYP inducers (rifampicin, St John's Wort, carbamazepine, phenytoin): CONTRAINDICATED — dramatically reduce drug levels.

•       Antacids (aluminium/magnesium hydroxide): separate by at least 4 hours.

•       Proton pump inhibitors (omeprazole, lansoprazole): take sofosbuvir/velpatasvir with food, and PPI at the same time or within 4 hours; limit to omeprazole 20 mg equivalent dose.

•       H2-receptor antagonists (ranitidine, famotidine): take simultaneously or 12 hours apart.

•       Amiodarone: CONTRAINDICATED.

•       Statins (rosuvastatin, atorvastatin): dose adjustment or monitoring required due to increased statin exposure.

•       Digoxin: increased levels — monitor.

•       Tenofovir-containing HIV regimens: increased tenofovir exposure — monitor renal function and bone density.

Store below 30°C. Keep in original packaging. Keep out of reach of children. Do not use after the expiry date.

A 12-week course of sofosbuvir/velpatasvir cures hepatitis C in more than 95% of patients — this is a remarkable achievement for a once-deadly infection. To maximise your chances of cure, take every tablet, at the same time each day, for the full 12 weeks. Missing doses significantly reduces your chances of cure.

Being cured of hepatitis C means the virus becomes undetectable in your blood 12 weeks after completing treatment (SVR12). Your liver can still carry some scarring (fibrosis or cirrhosis) from the years of infection — your doctor will monitor you for this, and for liver cancer screening in patients with cirrhosis.

Test and treat all close contacts and household members who may have been exposed — hepatitis C is transmitted primarily through blood-to-blood contact.

Sofosvel (sofosbuvir/velpatasvir) is the generic/branded generic equivalent of Epclusa (Gilead). It is pan-genotypic — no HCV genotyping is required before prescribing. SVR12 rates: GT1–6 without cirrhosis — 99%; with compensated cirrhosis — 99%; with decompensated cirrhosis (+ ribavirin) — 83–94%. Screen all patients for HBV co-infection before starting (FDA black box warning since 2016).

Drug interactions are principally mediated by OATP1B/P-gp/BCRP — the most clinically significant are potent inducers (absolute contraindication) and amiodarone (absolute contraindication). For patients on acid-reducing agents: H2 antagonists and low-dose PPIs can be managed with timing adjustments; high-dose PPI should be avoided if possible. Renal impairment: no dose adjustment needed if eGFR >30; for eGFR <30 — specialist guidance required.

Is this a cure for hepatitis C?

Yes — in the vast majority of patients. Achieving SVR12 (undetectable HCV in blood 12 weeks after completing treatment) is considered a virological cure. Your immune system cannot clear any remaining scar tissue from your liver, but the virus itself will be eliminated.

Can I drink alcohol while taking this treatment?

Alcohol causes liver inflammation and accelerates liver damage, which counteracts the benefit of clearing HCV. Ideally avoid alcohol completely during and after treatment, especially if you have any degree of cirrhosis.

Do I need to tell my partner about my hepatitis C?

Yes — hepatitis C can be transmitted through shared needles, blood contact, and potentially (less efficiently) through sexual contact. Partners should be tested and treated if positive.

What if I miss a dose?

If you remember within 18 hours of your scheduled dose, take it immediately. If more than 18 hours have passed, skip the missed dose and continue the next day. Do not double up.

I have cirrhosis — is this treatment safe for me?

Yes — sofosbuvir/velpatasvir is used in patients with compensated and decompensated cirrhosis. In decompensated cirrhosis, ribavirin is added to the regimen. Patients with cirrhosis require closer monitoring and ongoing liver cancer surveillance after treatment.