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Pan-genotypic DAA combination

Sofosbuvir with velpatasvir

Brand names: Epclusa

Adult dose

Dose: 400/100mg PO OD for 12 weeks
Route: PO
Frequency: OD

Clinical pearls

  • Pan-genotypic HCV (genotypes 1-6); compensated cirrhosis OK
  • Screen HBV before

Contraindications

  • Concurrent amiodarone
  • Strong CYP/P-gp inducers (rifampicin, carbamazepine, St John's wort)
  • Hypersensitivity

Side effects

  • Headache
  • Fatigue
  • Nausea
  • HBV reactivation
  • Bradycardia (with amiodarone)

Interactions

  • Amiodarone
  • Statins (limit rosuvastatin)
  • PPIs (separate / limit dose)
  • Antacids

Monitoring

  • LFTs
  • HCV RNA
  • HBV DNA

Reference: BNF; NICE TA430; EASL; https://bnf.nice.org.uk/drugs/sofosbuvir-with-velpatasvir/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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