What is Epclusa?
Epclusa is prescribed to treat chronic hepatitis C virus infections in adults and children 3 years+. It works against different virus types regardless of severe liver damage. It contains sofosbuvir and velpatasvir.
For advanced liver damage, Epclusa may be combined with ribavirin. Before starting, discuss medical conditions like hepatitis B, liver issues, kidney problems, HIV, and pregnancy with your healthcare provider.
Women using Epclusa with ribavirin should avoid pregnancy during and post-treatment. When breastfeeding, consult your healthcare provider on the safest feeding method during Epclusa treatment.
How Does Epclusa Work?
Epclusa works by combining two ingredients: sofosbuvir and velpatasvir, which directly attack the hepatitis C virus.
Sofosbuvir acts by blocking an enzyme known as NS5B, which is crucial for the virus to replicate itself inside liver cells. This action prevents the virus from making copies of itself, essentially halting its ability to spread and cause further damage to the liver.
Velpatasvir targets another protein called NS5A, which is involved in the virus’s ability to assemble and spread within the body. By blocking NS5A, Epclusa further disrupts the virus’s lifecycle, preventing it from infecting new cells and continuing its harmful effects.
Dosage Information and Usage
Dosage Form and Strengths of Epclusa
Epclusa is available in two forms for oral use: tablets and oral pellets.
Tablets:
- 400 mg sofosbuvir + 100 mg velpatasvir (pink, film-coated)
- 200 mg sofosbuvir + 50 mg velpatasvir (pink, film-coated)
Oral Pellets:
- 200 mg sofosbuvir + 50 mg velpatasvir (white to off-white, in unit-dose packets)
- 150 mg sofosbuvir + 37.5 mg velpatasvir (white to off-white, in unit-dose packets)
Usage
Epclusa is prescribed for the treatment of chronic hepatitis C virus (HCV) infection in patients aged 3 years and older.
The recommended dosage depends on the patient’s age, weight, and severity of liver disease.
For adults, the usual dose is one 400 mg/100 mg tablet taken orally once daily with or without food. Pediatric patients, depending on their weight, may take either oral pellets or tablets once daily as prescribed by their healthcare provider.
It’s important to follow your healthcare provider’s instructions carefully and not miss doses, as this can affect the effectiveness of the treatment.
If your child has difficulty swallowing tablets, your healthcare provider may recommend oral pellets, which can be mixed with non-acidic soft foods for easier administration.
Storage Information
Store Epclusa tablets and oral pellets below 30°C (86°F). Keep the tablets in their original bottle with a child-resistant cap. Each bottle contains 28 tablets.
For oral pellets, keep them in their original cartons. Do not use the oral pellets if the seal on the carton or packet is broken or damaged.
Side Effects of Epclusa
Common Side Effects
- Headache
- Tiredness
- Nausea (especially when used with ribavirin)
- Trouble sleeping (especially when used with ribavirin)
- Diarrhea (especially when used with ribavirin)
- Vomiting (more common in children under 6 years old)
Serious but Rare Side Effects:
- Reactivation of hepatitis B virus
- Slow heart rate (bradycardia), especially when taken with amiodarone, which can lead to:
- Fainting or near-fainting
- Dizziness or lightheadedness
- Feeling unwell
- Weakness
- Extreme tiredness
- Shortness of breath
- Chest pains
- Confusion
- Memory problems
Warnings and Precautions
- Risk of Hepatitis B Virus Reactivation: Epclusa can reactivate hepatitis B in patients with both hepatitis C and B, leading to severe liver problems like fulminant hepatitis (acute liver failure), liver failure, and even death. Patients should be tested for HBV before starting Epclusa and monitored during and after treatment.
- Serious Symptomatic Bradycardia: Taking Epclusa with amiodarone, a heart medication, can cause a dangerously slow heart rate (bradycardia) with severe symptoms such as fainting, dizziness, extreme tiredness, shortness of breath, chest pain, and confusion. Patients may need close heart monitoring if they need both medications.
- Risk of Reduced Effectiveness with Certain Drugs: Some drugs, like rifampin, St. John’s wort, and carbamazepine, can reduce the effectiveness of Epclusa by lowering its blood levels. Patients should avoid these drugs while on Epclusa.
- Risks with Ribavirin Combination Treatment: When used with ribavirin, Epclusa carries the additional risks associated with ribavirin, such as anemia, birth defects, and heart problems. Patients should follow ribavirin-specific warnings and precautions.
Overdosage of Epclusa
If someone takes too much Epclusa, there is no specific antidote to counteract the overdose. The patient needs to be watched closely for any signs of toxicity.
Treatment involves general supportive care, which means checking vital signs and observing the patient’s overall condition.
Hemodialysis can help remove a significant amount of the main metabolite of sofosbuvir (a component of Epclusa), but it is not very effective for removing velpatasvir, another component of Epclusa, because it binds strongly to proteins in the blood.
Drug Interactions With Other Medications
- Drugs that Lower Epclusa’s Effectiveness: Some drugs, such as rifampin (used for tuberculosis) and St. John’s wort (a herbal supplement for depression), can decrease the levels of Epclusa in your blood, making it less effective. It’s important to avoid using these drugs while taking Epclusa.
- Epclusa Increasing Other Drugs’ Levels: Epclusa can increase the levels of certain drugs in your body by affecting transport proteins like P-gp and BCRP. This means other medications you are taking might need their doses adjusted to avoid potential side effects.
- Liver Function Changes: Epclusa can change how your liver functions, which might impact how other medications work. This is particularly important for people with diabetes, as it can affect blood sugar control, or those taking warfarin, as it can affect blood clotting. Regular monitoring of blood sugar and blood clotting parameters is recommended.
- Acid Reducing Agents: Medications that reduce stomach acid, such as antacids, H2-receptor antagonists (like famotidine), and proton-pump inhibitors (like omeprazole), can lower the levels of velpatasvir in Epclusa. To prevent this, antacids should be taken at least 4 hours apart from Epclusa. For H2-receptor antagonists, they can be taken at the same time or 12 hours apart. Proton-pump inhibitors should generally be avoided, but if necessary, Epclusa should be taken with food and at least 4 hours before the proton-pump inhibitor.
- Antiarrhythmics: Amiodarone, a medication used to treat irregular heartbeats, can cause a dangerously slow heart rate when taken with Epclusa. If you need to take both, you should be monitored closely in a hospital setting, especially during the first 48 hours of starting this combination, and continue monitoring your heart rate at home for at least the first two weeks.
- Anticancer Drugs: The anticancer drug topotecan can increase in your body if taken with Epclusa, which might lead to more side effects. Therefore, this combination is not recommended.
- Anticonvulsants: Medications used to control seizures, such as carbamazepine, phenytoin, and phenobarbital, can lower the levels of Epclusa, making it less effective. These drugs should be avoided while taking Epclusa.
- Antimycobacterials: Medications like rifabutin, rifampin, and rifapentine, used to treat infections like tuberculosis, can reduce the levels of Epclusa, decreasing its effectiveness. Avoid using these medications with Epclusa.
- HIV Antiretrovirals: Some HIV medications, like efavirenz and those containing tenofovir DF, can interact with Epclusa. This can either decrease Epclusa’s effectiveness or increase the levels of tenofovir, leading to side effects. Close monitoring and possibly adjusting the dose of these HIV medications is necessary.
- Herbal Supplements: St. John’s wort, a herbal supplement for depression, can lower the levels of Epclusa, making it less effective. It’s important not to use St. John’s wort while taking Epclusa.
- HMG-CoA Reductase Inhibitors: Medications like rosuvastatin and atorvastatin, used to lower cholesterol, can increase in concentration when taken with Epclusa, raising the risk of muscle problems such as myopathy or rhabdomyolysis. If you need to take these drugs with Epclusa, your doctor may lower the dose of the cholesterol medication and monitor you closely for muscle-related side effects.
Cost & Discounts
Epclusa Canada
Your health is our priority at Pharma Giant, where we strive to make high-quality healthcare both affordable and accessible. We understand that the cost of medication can be a significant concern.
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Explore our Epclusa options: 400mg/100mg (28 tablets) for $22,654.95.
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With our reliable express shipping service, you can anticipate receiving your order within 3-5 business days anywhere in the United States. We meticulously package your order in secure containers to ensure the utmost protection of your medication during transit.
We strive to make essential treatments accessible and affordable for everyone, including those without insurance.
Frequently Asked Questions
Disclaimer
Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.
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