DAA HCV (NS5A + NS5B inhibitor)
Ledipasvir with sofosbuvir
Brand names: Harvoni
Adult dose
Dose: 1 tab (90mg ledipasvir / 400mg sofosbuvir) OD for 8–24 weeks per genotype/cirrhosis status
Route: PO
Frequency: OD
Clinical pearls
- Genotype 1, 4, 5, 6 HCV; superseded by pan-genotypic regimens (glecaprevir/pibrentasvir, sofosbuvir/velpatasvir) in many settings
- Screen HBV
Contraindications
- Concurrent rifampicin/St John's wort/carbamazepine/phenytoin
- Severe renal impairment (caution sofosbuvir)
- Concurrent amiodarone (severe bradycardia risk)
Side effects
- Headache
- Fatigue
- Insomnia
- Bradycardia (with amiodarone)
- HBV reactivation
Interactions
- P-gp inducers reduce levels
- Drugs raising gastric pH (PPIs/H2)
- Amiodarone — avoid
- Statins (rosuvastatin)
Monitoring
- LFTs
- HBsAg
- HCV RNA
Reference: BNF; NICE TA363; EASL HCV guidelines; https://bnf.nice.org.uk/drugs/ledipasvir-with-sofosbuvir/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023