without end [30:<18 years of age. 1 Geriatric Use No overall differences in safety and efficacy in patients ≥65 years of age compared with younger adults, but increased sensitivity in some older individuals cannot be ruled out. 1 Hepatic Impairment HCV-infected individuals with moderate or severe hepatic impairment (Child-Pugh class B or C): Increased sofosbuvir and GS-331007 exposures compared with those in individuals with normal hepatic function. 1 Moderate or severe hepatic impairment (Child-Pugh class B or C) without HCV infection: Velpatasvir exposure similar to exposure in individuals with normal hepatic function. 1 When velpatasvir/sofosbuvir is used in conjunction with ribavirin in patients with decompensated cirrhosis (Child-Pugh class B or C), clinical and hepatic laboratory monitoring is recommended as clinically indicated. 1 Renal Impairment Mild, moderate, or severe renal impairment without HCV infection: Increased sofosbuvir and GS-331007 exposures compared with those in individuals with normal renal function. 1 ESRD without HCV infection: Increased sofosbuvir and GS-331007 exposures when administered 1 hour before or 1 hour after hemodialysis compared with exposures in individuals with normal renal function. 1 Severe renal impairment without HCV infection: Velpatasvir exposure similar to exposure in healthy individuals. 1 Common Adverse Effects Sofosbuvir/velpatasvir in patients without cirrhosis or with compensated cirrhosis: Headache, 1 2 4 fatigue, 1 2 4 nasopharyngitis, 2 4 nausea, 2 4 insomnia. 4 Sofosbuvir/velpatasvir in conjunction with ribavirin in patients with decompensated cirrhosis: Fatigue, 1 3 anemia, 1 3 nausea, 1 3 headache, 1 3 insomnia, 1 3 diarrhea, 1 3 muscle spasm, 3 dyspnea, 3 cough. 3 Interactions for Epclusa In vitro studies indicate slow metabolic turnover of velpatasvir by CYP2B6, 2C8, and 3A4. 1 Velpatasvir inhibits P-gp transport system; 1 sofosbuvir and velpatasvir are substrates of P-gp. 1 Velpatasvir inhibits breast cancer resistance protein (BCRP); 1 sofosbuvir and velpatasvir are substrates of BCRP. 1 Velpatasvir transported by organic anion transporting polypeptide (OATP) 1B1 and 1B3; 1 velpatasvir inhibits OATP1B1, 1B3, and 2B1. 1 The following drug interactions are based on studies using sofosbuvir/velpatasvir, sofosbuvir alone, or velpatasvir alone, or are predicted to occur. 1 When sofosbuvir/velpatasvir used, consider interactions associated with both drugs in the fixed combination. 1 Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes Moderate or potent CYP2B6, 2C8, or 3A4 inducers: Possible decreased sofosbuvir and/or velpatasvir plasma concentrations leading to reduced therapeutic effect; 1 concomitant use of sofosbuvir/velpatasvir with such inducers not recommended. 1 CYP2B6, 2C8, or 3A4 inhibitors: Possible increased velpatasvir plasma concentrations; 1 sofosbuvir/velpatasvir may be used concomitantly with such inhibitors. 1 Drugs Affecting or Affected by P-glycoprotein Transport System P-gp substrates: Intestinal absorption may be affected resulting in increased exposure of such substrates. 1 P-gp inducers: Possible decreased sofosbuvir and/or velpatasvir plasma concentrations leading to reduced therapeutic effect; 1 concomitant use of sofosbuvir/velpatasvir with P-gp inducers not recommended. 1 P-gp inhibitors: Possible increased sofosbuvir and/or velpatasvir concentrations; 1 sofosbuvir/velpatasvir may be used concomitantly with P-gp inhibitors. 1 Drugs Affecting or Affected by Breast Cancer Resistance Protein BCRP substrates: Intestinal absorption may be affected resulting in increased exposure of such substrates. 1 BCRP inhibitors: Possible increased sofosbuvir and/or velpatasvir concentrations; 1 sofosbuvir/velpatasvir may be used concomitantly with BCRP inhibitors. 1 Drugs Affecting or Affected by Organic Anion Transporting Polypeptides OATP1B1, 1B3, or 2B1 substrates: Intestinal absorption may be affected resulting in increased exposure of such substrates. 1 Specific Drugs Drug Interaction Comments Antacids (aluminum and magnesium hydroxides) Decreased velpatasvir concentrations expected; 1 increased gastric pH decreases velpatasvir solubility 1 Take antacids 4 hours before or after sofosbuvir/velpatasvir 1 Antiarrhythmic agents (amiodarone) Amiodarone: Concomitant use with sofosbuvir/velpatasvir may result in serious symptomatic bradycardia; 1 23 effect on amiodarone, sofosbuvir, and velpatasvir concentrations unknown 1 Amiodarone: Concomitant use with sofosbuvir/velpatasvir not recommended; 1 if concomitant use necessary, patient counseling and cardiac monitoring required 1 (see Cardiovascular Effects under Cautions) Anticonvulsants (carbamazepine, oxcarbazepine, phenobarbital, phenytoin) Carbamazepine, oxcarbazepine, phenobarbital, phenytoin: Decreased sofosbuvir and velpatasvir concentrations expected 1 Carbamazepine, oxcarbazepine, phenobarbital, phenytoin: Concomitant use with sofosbuvir/velpatasvir not recommended 1 Antifungals, azoles (ketoconazole) Ketoconazole: No clinically important pharmacokinetic interactions with velpatasvir 1 Antimycobacterial agents (rifabutin, rifampin, rifapentine) Rifabutin, rifapentine: Decreased sofosbuvir and velpatasvir concentrations expected 1 Rifampin: Decreased sofosbuvir and velpatasvir concentrations and AUCs 1 6 Rifabutin, rifampin, rifapentine: Concomitant use with sofosbuvir/velpatasvir not recommended 1 Atazanavir Ritonavir-boosted atazanavir: No clinically important pharmacokinetic interactions 1 HIV antiretroviral regimen of ritonavir-boosted atazanavir in conjunction with fixed combination of emtricitabine and tenofovir disoproxil fumarate (emtricitabine/tenofovir DF): Increased velpatasvir and tenofovir concentrations and AUC 1 HIV antiretroviral regimens that include ritonavir-boosted atazanavir and tenofovir DF: Monitor for tenofovir-associated adverse effects 1 Darunavir Ritonavir-boosted darunavir: No clinically important pharmacokinetic interactions 1 HIV antiretroviral regimen of ritonavir-boosted darunavir in conjunction with emtricitabine/tenofovir DF: Decreased sofosbuvir and velpatasvir concentrations and AUC; 1 increased tenofovir concentrations and AUC 1 HIV antiretroviral regimens that include ritonavir-boosted darunavir and tenofovir DF: Monitor for tenofovir-associated adverse effects 1 Digoxin Increased digoxin concentrations and AUC when used concomitantly with velpatasvir 1 Digoxin therapeutic concentration monitoring recommended if used concomitantly with sofosbuvir/velpatasvir 1 Dolutegravir No clinically important pharmacokinetic interactions with sofosbuvir/velpatasvir 1 Efavirenz Fixed combination of efavirenz, emtricitabine, and tenofovir DF (efavirenz/emtricitabine/tenofovir DF): No clinically important effect on sofosbuvir pharmacokinetics; 1 decreased velpatasvir concentrations and AUC; increased tenofovir concentrations and AUC 1 HIV antiretroviral regimens containing efavirenz: Concomitant use with sofosbuvir/velpatasvir not recommended 1 Elvitegravir Fixed combination of elvitegravir, cobicistat, emtricitabine, and tenofovir DF (EVG/c/FTC/TDF): No clinically important effect on sofosbuvir, velpatasvir, elvitegravir, cobicistat, or emtricitabine pharmacokinetics; 1 increased tenofovir concentrations and AUC 1 Fixed combination of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (EVG/c/FTC/TAF): No clinically important pharmacokinetic interactions 1 EVG/c/FTC/TDF: Monitor for tenofovir-associated adverse effects 1 Emtricitabine No clinically important pharmacokinetic interactions with sofosbuvir/velpatasvir 1 Estrogens/progestins Oral contraceptive containing ethinyl estradiol and norgestimate: No clinically important effects on pharmacokinetics of ethinyl estradiol or norgestimate and its active metabolites (norelgestromin, norgestrel) 1 Histamine H 2 -receptor antagonists Decreased velpatasvir concentrations expected; 1 increased gastric pH decreases velpatasvir solubility 1 Administer H 2 -antagonists concurrently with or 12 hours apart from sofosbuvir/velpatasvir; 1 do not exceed H 2 -antagonist dosages comparable to famotidine 40 mg twice daily 1 HMG-CoA reductase inhibitors (statins) Atorvastatin: Increased atorvastatin concentrations expected; increased risk of myopathy and rhabdomyolysis 1 Pravastatin: No clinically important interactions 1 6 Rosuvastatin: Increased rosuvastatin concentrations; increased risk of myopathy and rhabdomyolysis 1 6 Atorvastatin: Closely monitor for statin-associated adverse effects (e.g., myopathy, rhabdomyolysis) 1 Rosuvastatin: Do not exceed rosuvastatin dosage of 10 mg daily 1 Immunosuppressants (cyclosporine, tacrolimus) Cyclosporine: No clinically important pharmacokinetic interactions with sofosbuvir or velpatasvir 1 Tacrolimus: No clinically important pharmacokinetic interactions with sofosbuvir 1 Interferons Interferon alfa: No in vitro evidence of antagonistic anti-HCV effects with sofosbuvir or velpatasvir 1 188 Lopinavir Fixed combination of lopinavir and ritonavir (lopinavir/ritonavir): No clinically important effect on sofosbuvir or velpatasvir pharmacokinetics 1 Methadone No clinically important pharmacokinetic interactions with sofosbuvir 1 Proton-pump inhibitors Decreased velpatasvir concentrations expected; 1 increased gastric pH decreases velpatasvir solubility 1 Concomitant use with sofosbuvir/velpatasvir not recommended 1 If concomitant use necessary, administer sofosbuvir/velpatasvir with food 4 hours before omeprazole 20 mg; 1 use with other proton-pump inhibitors not studied 1 Raltegravir HIV antiretroviral regimen of raltegravir in conjunction with emtricitabine/tenofovir DF: No clinically important effect on raltegravir or emtricitabine pharmacokinetics; 1 increased tenofovir plasma concentrations and AUC 1 HIV antiretroviral regimens that include raltegravir and tenofovir DF: Monitor for tenofovir-associated adverse effects 1 Ribavirin No in vitro evidence of antagonistic anti-HCV effects with sofosbuvir or velpatasvir 1 188 Rilpivirine Fixed combination of emtricitabine, rilpivirine, and tenofovir DF (emtricitabine/rilpivirine/tenofovir DF): No clinically important effect on emtricitabine or rilpivirine pharmacokinetics; 1 increased tenofovir concentrations and AUC 1 HIV antiretroviral regimens that include rilpivirine and tenofovir DF: Monitor for tenofovir-associated adverse effects 1 St. John's wort ( Hypericum perforatum ) Possible decreased sofosbuvir and velpatasvir concentrations 1 Concomitant use with sofosbuvir/velpatasvir not recommended 1 Tenofovir HIV antiretroviral regimens that include tenofovir DF: Possible increased tenofovir concentrations 1 HIV antiretroviral regimens that include tenofovir DF: Monitor for tenofovir-associated adverse effects 1 Tipranavir Ritonavir-boosted tipranavir: Decreased sofosbuvir and velpatasvir concentrations expected 1 Ritonavir-boosted tipranavir: Concomitant use with sofosbuvir/velpatasvir not recommended 1 Topotecan Increased topotecan concentrations expected 1 Concomitant use with sofosbuvir/velpatasvir not recommended 1 Warfarin Subtherapeutic INR reported after initiation of sofosbuvir-containing regimens in patients receiving warfarin 26 27 28 Closely monitor INR when initiating or discontinuing sofosbuvir-containing regimens 26 27 28 Epclusa Pharmacokinetics Absorption Bioavailability Following oral administration of sofosbuvir/velpatasvir, peak plasma concentrations of sofosbuvir occur approximately 0.5 1 hour after the dose. 1 7 Peak plasma concentrations and AUC of sofosbuvir and GS-331007 are similar in HCV-infected and healthy adults. 1 Following oral administration of sofosbuvir/velpatasvir, peak plasma concentrations of velpatasvir occur 3 hours after the dose. 1 7 Peak plasma concentrations and AUC of velpatasvir are 42 and 37% lower, respectively, in HCV-infected adults compared with healthy adults. 1 Food Administration of sofosbuvir/velpatasvir with moderate-fat (approximately 600 kcal, 30% fat) or high-fat (approximately 800 kcal, 50% fat) meal increased sofosbuvir exposures by 60 or 78%, respectively, 1 and increased velpatasvir exposures by 34 or 21%, respectively. 1 7 Special Populations Sofosbuvir: In HCV-infected individuals with moderate or severe hepatic impairment (Child-Pugh class B or C), sofosbuvir AUC is 126 or 143% higher, respectively, compared with individuals with normal hepatic function; 1 GS-331007 AUC is 18 or 9% higher, respectively. 1 Velpatasvir: In individuals with moderate or severe hepatic impairment (Child-Pugh class B or C) without HCV infection, AUC of velpatasvir after single 100-mg dose is similar to that observed in individuals with normal hepatic function. 1 Sofosbuvir: In individuals with mild, moderate, or severe renal impairment without HCV infection, sofosbuvir AUC after single 400-mg dose is 61, 107, or 171% higher, respectively, compared with individuals with normal renal function; 1 GS-331007 AUC is 55, 88, or 451% higher, respectively. 1 Velpatasvir: In individuals with severe renal impairment without HCV infection, no clinically important differences in velpatasvir pharmacokinetics after single 100-mg dose compared with healthy individuals. 1 Population pharmacokinetic analysis in HCV-infected individuals indicates cirrhosis does not substantially affect sofosbuvir, GS-331007, or velpatasvir exposures. 1 Population pharmacokinetic analysis in HCV-infected individuals indicates that gender and race do not affect sofosbuvir, GS-331007, or velpatasvir exposures. 1 Distribution Plasma Protein Binding Sofosbuvir: Approximately 61 65%. 1 Velpatasvir: >99.5%. 1 Elimination Metabolism Sofosbuvir: Prodrug that undergoes intracellular metabolic activation in the liver (hydrolysis by human cathepsin A [CatA] or carboxylesterase 1 [CES1], phosphoramidate cleavage by histidine triad nucleotide-binding protein 1 [HINT1], and phosphorylation by pyrimidine nucleotide biosynthesis pathway). 1 181 Results in formation of pharmacologically active metabolite, GS-461203. 1 181 Desphosphorylation subsequently occurs leading to formation of GS-331007 (the predominant circulating metabolite); 1 181 GS-331007 has no anti-HCV activity. 1 181 Velpatasvir: Metabolized by CYP2B6, 2C8, and 3A4. 1 Elimination Route Sofosbuvir: Major route of elimination is renal clearance. 1 Following single 400-mg oral dose, 80% eliminated in urine (mainly as GS-331007), 14% in feces, and 2.5% in expired air. 1 181 Velpatasvir: Major route of elimination is biliary excretion (approximately 77% of a dose eliminated as parent drug). 1 Following a single 100-mg oral dose, 94% eliminated in feces and 0.4% in urine. 1 7 Half-life Sofosbuvir: 0.5 hours; 1 GS-331007 has half-life of 25 hours. 1 Velpatasvir: 15 hours. 1 Special Populations Sofosbuvir: Hemodialysis (4-hour session) removes approximately 18% of dose. 1 Stability Storage Oral Film-coated Tablets> <30ºC. 1 Dispense only in original container. 1 Actions and Spectrum Sofosbuvir/velpatasvir is a fixed combination of 2 HCV antivirals. 1 Sofosbuvir is a nucleotide analog HCV NS5B polymerase inhibitor 1 and velpatasvir is an HCV NS5A replication complex inhibitor (NS5A inhibitor). 1 Sofosbuvir and velpatasvir are both DAAs with activity against HCV. 1 No in vitro evidence of antagonistic anti-HCV effects between the drugs in HCV replicon studies. 1 Sofosbuvir is a prodrug that undergoes metabolic activation in the liver to a pharmacologically active uridine analog triphosphate (GS-461203), which can be incorporated into HCV RNA by NS5B polymerase; 1 acts as RNA chain terminator. 1 In vitro studies using biochemical and cell-based replicon assays indicate that GS-461203 has activity against HCV genotypes 1b, 2a, 3a, and 4a. 1 5 Sofosbuvir has shown in vitro activity against full-length or chimeric replicons of HCV genotypes 1a, 1b, 2a, 2b, 3a, 4a, 4d, 5a, and 6a (mean drug concentration required to inhibit viral replication by 50% [EC 50 ] ranges from 14 110 nM). 1 5 Velpatasvir inhibits the HCV NS5A protein, which is required for viral replication. 1 Velpatasvir has shown in vitro activity against full-length or chimeric replicons of HCV genotypes 1a, 1b, 2a, 2b, 3a, 4a, 4d, 5a, 6a, and 6e (mean EC 50 ranges from 0.002 0.13 nM). 1 5 Certain amino acid substitutions in NS5B polymerase of HCV genotypes 1b, 2a, 2b, 3a, 4a, 5a, and 6a have been selected in cell culture and have been associated with reduced susceptibility to sofosbuvir in vitro in replicon studies. 1 In all replicon genotypes tested, the S282T substitution was associated with reduced susceptibility to sofosbuvir; 1 in genotypes 2a, 5, and 6 replicons, an M289L substitution developed along with the S282T substitution. 1 Treatment-emergent NS5B resistance-associated substitutions were detected in phase 3 clinical trials evaluating sofosbuvir/velpatasvir in patients with HCV genotype 3a infection (e.g., L314F, L314I, L314P) who experienced virologic failure. 1 Certain amino acid substitutions in NS5A of HCV genotype 1a (e.g., L31V, Y93H/N), genotype 1b (e.g., L31V, Y93H), genotype 2a (e.g., F28S, Y93H), genotype 3a (e.g., Y93H/S), genotype 4a (e.g., Y93H), and genotype 6 (e.g., L31V, P32A/L/Q/R) have been selected in cell culture and have been associated with reduced susceptibility to velpatasvir in vitro in replicon studies. 1 Combinations of these NS5A substitutions often resulted in greater reductions in susceptibility to velpatasvir compared with a single NS5A substitution. 1 Treatment-emergent NS5A resistance-associated substitutions were detected in phase 3 clinical trials evaluating sofosbuvir/velpatasvir in patients with HCV genotype 1a (e.g., Y93N, Q30R, H58D), genotype 1b (e.g., L31M/V, Y93H), genotype 1c/h (e.g., Y93H, K24M/T, L31I/V), or genotype 3a (e.g., Y93H, M28T/V, S38P/Y, P58L, A30V, H58T) infection who experienced virologic failure. 1 3 5 Some of these patients also had baseline NS5A polymorphisms at resistance-associated amino acid positions. 1 3 5 Sofosbuvir and velpatasvir are active against HCV with substitutions associated with resistance to other HCV DAAs with different mechanisms of action (e.g., HCV NS5B polymerase inhibitors, HCV NS3 protease inhibitors). 1 Efficacy of sofosbuvir/velpatasvir not established in patients in whom previous treatment with a regimen that included an HCV NS5A inhibitor failed. 1 Advice to Patients Importance of reading patient information provided by the manufacturer. 1 Advise patients to take sofosbuvir/velpatasvir once daily (with or without food) on a regular dosing schedule. 1 Importance of taking the recommended dosage of sofosbuvir/velpatasvir for the recommended duration of treatment; 1 importance of not missing doses. 1 Inform patients that reactivation of HBV infection has occurred in coinfected patients being treated for HCV infection. 1 25 Importance of informing clinician of any history of HBV infection or other liver problems (e.g., cirrhosis). 1 25 Importance of immediately contacting a clinician if any signs or symptoms of serious liver injury (e.g., fatigue, weakness, loss of appetite, nausea and vomiting, yellowing of the eyes or skin, light-colored bowel movements) occur. 25 (See Risk of HBV Reactivation in Patients Coinfected with HCV and HBV under Cautions.) If sofosbuvir/velpatasvir is used in a patient receiving amiodarone, advise the patient about the risk of serious symptomatic bradycardia and the importance of immediately contacting a clinician if signs or symptoms of bradycardia (e.g., near-fainting or fainting, dizziness, lightheadedness, malaise, weakness, excessive tiredness, shortness of breath, chest pain, confusion, memory problems) occur. 1 (See Cardiovascular Effects under Cautions.) Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements, as well as any concomitant illnesses. 1 Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 1 If used in conjunction with ribavirin, advise men and women of importance of using 2 forms of effective contraception during and for 6 months after ribavirin therapy. 1 349 377 (See Precautions Related to Fixed Combinations and Multiple-drug Treatment Regimens under Cautions.) Importance of informing patients of other important precautionary information. 1 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Sofosbuvir and Velpatasvir Routes Dosage Forms Strengths Brand Names Manufacturer Oral Tablets, film-coated Sofosbuvir 400 mg and Velpatasvir 100 mg Epclusa Gilead AHFS DI Essentials. Copyright 2017, Selected Revisions October 9, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 1. Gilead Sciences, Inc. Epclusa (sofosbuvir and velpatasvir) tablets prescribing information. Foster City, CA; 2017 Feb. 2. Feld JJ, Jacobson IM, Hézode C et al. Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection. N Engl J Med . 2015; 373:2599-607. [PubMed 26571066] 3. Curry MP, O'Leary JG, Bzowej N et al. Sofosbuvir and velpatasvir for HCV in patients with decompensated cirrhosis. N Engl J Med . 2015; 373:2618-28. [PubMed 26569658] 4. Foster GR, Afdhal N, Roberts SK et al. Sofosbuvir and velpatasvir for HCV genotype 2 and 3 infection. N Engl J Med . 2015; 373:2608-17. [PubMed 26575258] 5. US Food and Drug Administration. Center for Drug Evaluation and Research. Application number 208341Orig1s000: Microbiology review(s). From FDA website. 6. Mogalian E, German P, Kearney BP et al. Use of Multiple Probes to Assess Transporter- and Cytochrome P450-Mediated Drug-Drug Interaction Potential of the Pangenotypic HCV NS5A Inhibitor Velpatasvir. Clin Pharmacokinet . 2016; 55:605-13. [PubMed 26519191] 7. US Food and Drug Administration. Center for Drug Evaluation and Research. Application number 208341Orig1s000: Clinical pharmacology and biopharmaceutics review. From FDA website. 23. US Food and Drug Administration. FDA drug safety communication: FDA warns of serious slowing of the heart rate when antiarrhythmic drug amiodarone is used with hepatitis C treatments containing sofosbuvir (Harvoni) or Sovaldi in combination with another direct acting antiviral. 2015 Mar 24. From FDA website. 25. US Food and Drug Administration. FDA drug safety communication: FDA warns about the risk of hepatitis B reactivating in some patients treated with direct-acting antivirals for hepatitis C. 2016 Oct 4. From FDA website. 26. Britnell SR, Willets AE, Vanderman AJ et al. Influence of Successful Chronic Hepatitis C Virus Treatment with Ledipasvir/Sofosbuvir on Warfarin Dosing Requirements in Four Veterans. Pharmacotherapy . 2016; 36:1173-1179. [PubMed 27716978] 27. DeCarolis DD, Westanmo AD, Chen YC et al. Evaluation of a Potential Interaction Between New Regimens to Treat Hepatitis C and Warfarin. Ann Pharmacother . 2016; 50:909-917. [PubMed 27465881] 28. Peterson D, Van Ermen A. Increased warfarin requirements in a patient with chronic hepatitis C infection receiving sofosbuvir and ribavirin. Am J Health Syst Pharm . 2017; 74:888-892. [PubMed 28596225] 119. American Association for the Study of Liver Diseases (AASLD). Recommendations for testing, managing, and treating hepatitis C. From the AASLD website. Accessed 2017 May 8. 181. Gilead Sciences, Inc. Harvoni (ledipasvir and sofosbuvir) tablets prescribing information. Foster City, CA; 2017 Apr. 188. Gilead Sciences, Inc. Sovaldi (sofosbuvir) tablets prescribing information. Foster City, CA; 2017 Apr. 349. Merck Sharp & Dohme Corporation. Rebetol (ribavirin) capsules and oral solution prescribing information. Whitehouse Station, NJ; 2013 Nov. 377. Genentech. Copegus (ribavirin) tablets prescribing information. South San Francisco, CA; 2013 Feb. Next Interactions Print this page Add to My Med List More about Epclusa (sofosbuvir / velpatasvir) Side Effects During Pregnancy Dosage Information Drug Images Drug Interactions Compare Alternatives Support Group Pricing & Coupons En Español 75 Reviews Add your own review/rating Drug class: antiviral combinations Consumer resources Epclusa Epclusa (Advanced Reading) Professional resources Epclusa (FDA) Sofosbuvir and Velpatasvir (AHFS Monograph) Related treatment guides Hepatitis C> ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Manufacturer Gilead Sciences, Inc. Drug Class Antiviral combinations Related Drugs Hepatitis C Harvoni , ribavirin , Zepatier , Mavyret , Sovaldi , sofosbuvir , ledipasvir / sofosbuvir , Viekira Pak , Vosevi , daclatasvir , Daklinza , Pegasys , Intron A , Ribasphere , Olysio , sofosbuvir / velpatasvir , Rebetol , simeprevir , Moderiba , PegIntron , glecaprevir / pibrentasvir , elbasvir / grazoprevir , Victrelis , More... Epclusa Rating 75 User Reviews 8.0 /10 75 User Reviews 8.0 Rate it! Epclusa Images Epclusa sofosbuvir 400 mg / velpatasvir 100 mg (GSI 7916) View larger images} } corporation
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