Direct-acting antiviral (NS5B inhibitor)

Sofosbuvir

Brand names: Sovaldi

Sofosbuvir is a direct-acting antiviral nucleotide analogue used, in combination with other agents, to treat chronic hepatitis C virus infection.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Its active metabolite inhibits the hepatitis C NS5B RNA-dependent RNA polymerase, terminating viral RNA replication.

Prescribing in practice

Co-administration with amiodarone can cause severe symptomatic bradycardia and is generally avoided.
It is always used as part of a combination regimen, never as monotherapy.
Potent enzyme inducers such as certain anticonvulsants and rifampicin can substantially lower its levels and are contraindicated.

Monitoring

Monitor hepatitis C viral load to confirm sustained virological response and assess hepatic function during treatment.

Counselling the patient

Take the full course exactly as prescribed to clear the infection.
Tell your clinician if you take amiodarone for heart rhythm problems.
Avoid starting new medicines without checking, as some reduce this treatment's effectiveness.

Evidence & guidelines

Sofosbuvir-based regimens achieve high cure rates in chronic hepatitis C and are recommended in NICE guidance.

Reference: NICE TA330; BHIVA/EASL; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways