Velpanat (generic epclus) Velpatasvir 100mg + Sofosbuvir 400mg NATCO India

Epclusa is a pan-genotypic combination indicated for interferon-free therapy for HCV genotypes 1 to 6.

Active substance:
Velpatasvir 100 mg and Sofosbuvir 400 mg

Manufacturer:
Gilead Sciences International Ltd, Cambridge

Generic manufacturer NATCO India

Indications:
Epclusa is used to treat chronic hepatitis C for all genotypes of the virus (1-6) without cirrhosis, with compensated or decompensated cirrhosis of the liver (in combination with ribavirin).

Description:
Epclusa single tablet contains fixed doses of sofosbuvir (an inhibitor of hepatitis C virus NS5B polymerase) and velpatasvir (an NS5A inhibitor) for the treatment of adult patients with chronic hepatitis C infected with all major genotypes (1, 2, 3, 4, 5 or 6) .

Sofosbuvir, as you know, was developed and approved back in 2013, and velpatasvir appeared more recently.
It is the first drug to treat patients with genotype 2 and 3 virus without the need for ribavirin.

Dosage:
It is the first combination drug with a one tablet once daily regimen. Based on the FDA's conclusion, Epclusa is able to overcome all six genotypes of the hepatitis C virus; complete cure is guaranteed in 95% of patients.

In addition to the fact that the drug is intended for the treatment of all HCV genotypes, a feature of the use of this combination is that without cirrhosis and with compensated cirrhosis (Child-Pugh class A), the duration of therapy is 12 weeks, without the use of ribavirin. In decompensated cirrhosis (grade B and C), double the duration of 24 weeks and combination with ribavirin are recommended.

Side effects:
There is a risk of bradycardia when Epclusa is used with amiodarone and other direct-acting hepatitis C drugs. The risk is especially high in patients taking beta-blockers for cardiovascular disease and / or in patients with advanced liver disease. For patients for whom there is no other alternative, cardiac monitoring is recommended. If symptoms of brachycardia occur, medical attention should be sought immediately.
The most common adverse reactions (≥10%) of Epclus are headache and fatigue; when used with Ribavirin in cases with decompensated cirrhosis, fatigue, anemia, nausea, headache, insomnia, and diarrhea have been noted.

Interaction with other drugs:
The use of Sofosbuvir and Velpatasvir is not recommended with drugs that are P-gp inducers and/or CYP2B6 inducers, as these combinations may lead to a significant decrease in plasma levels of Sofosbuvir and Velpatasvir. Note that Velpatasvir's solubility decreases as gastric pH increases and drugs that increase gastric pH may decrease Velpatasvir concentrations; co-administration of proton pump inhibitors with Epclusa is also not recommended.