Hepcvel® Tablets

Description

Sofosbuvir 400mg + Velpatasvir 100mg Tablets are an oral, direct-acting antiviral (DAA) combination used in the treatment of chronic hepatitis C virus (HCV) infection. It is one of the first pan-genotypic regimens, providing coverage for all six major HCV genotypes (GT1–GT6). The combination is co-formulated into a single tablet taken once daily, with or without food.

This fixed-dose combination is most commonly known under the brand name Epclusa, marketed by Gilead Sciences. Generic versions are widely available across different markets, significantly reducing the Epclusa generic price and improving global accessibility.

Brand Names by Region

United States: Epclusa (Gilead Sciences)
Canada: Epclusa (Gilead Sciences Canada)
European Union: Epclusa (Gilead Sciences International)
United Kingdom: Epclusa
Australia: Epclusa (Gilead Sciences Pty Ltd)

How Sofosbuvir-Velpatasvir Works

Sofosbuvir is a nucleotide analog HCV NS5B polymerase inhibitor. It acts as a defective substrate for the viral RNA polymerase, thus terminating RNA synthesis.
Velpatasvir is an HCV NS5A inhibitor that blocking viral replication and assembly.

Together, they inhibit viral replication by targeting different points in the HCV replication cycle. Their synergistic action results in high sustained virologic response (SVR) rates, often interpreted as a functional cure.

Source: FDA Drug Label – Epclusa

Indications and Usage

Approved for use in:

• Adults and pediatric patients ≥3 years with chronic HCV genotypes 1–6

• Patients with or without compensated cirrhosis (Child-Pugh A)

• In combination with ribavirin for decompensated cirrhosis (Child-Pugh B or C)

Off-label uses are minimal due to the targeted nature of the drug. However, the combination has been explored in clinical settings for co-infections with hepatitis B and HIV, liver transplant patients, and those with renal impairment with promising results, though these require specialist oversight.

Source: AASLD-IDSA HCV Guidance

Dosage and Administration

• Standard dose: One tablet (Sofosbuvir 400mg + Velpatasvir 100mg) once daily

• Duration: 12 weeks for most patients

• In decompensated cirrhosis: Administered with ribavirin

Tablets should be swallowed whole and not crushed or chewed. Adherence is critical for treatment success.

Side Effects and Safety

Most common adverse reactions:

• Headache

• Fatigue

• Nausea

Severe adverse effects are rare but include bradycardia when used with amiodarone. Liver function should be monitored in patients with decompensated liver disease.

Source: Mayo Clinic – Sofosbuvir and Velpatasvir

Drug Interactions

Contraindicated with:

• Rifampin

• St. John’s Wort

• Carbamazepine

These reduce the plasma concentration of velpatasvir or sofosbuvir, lowering efficacy.

Caution in patients taking antacids or proton-pump inhibitors—acid-reducing agents may interfere with velpatasvir absorption.

Resistance and Efficacy

The combination exhibits a high genetic barrier to resistance. Clinical trials report SVR rates over 95%, even among difficult-to-treat populations, including those with prior treatment failure or advanced liver disease.

Availability and Cost

The cost of Epclusa in the US can exceed $24,000 for a 12-week course. However, Epclusa cost without insurance varies significantly based on the pharmacy and available discount programs.

Generic alternatives have substantially reduced the Epclusa 400 mg 100 mg tablet price in India and other markets, with the Epclusa generic price as low as $300–$900 for a full course depending on the supplier and region.

Patients are encouraged to compare the Epclusa price through legitimate online pharmacies or seek patient assistance programs for affordability.

Source: 1mg.com – Sofosbuvir Velpatasvir Prices

Clinical Trials and Novel Insights

Recent studies have highlighted successful HCV eradication using this regimen even in marginalized groups, including intravenous drug users and incarcerated individuals. The simplicity of once-daily dosing makes it feasible for mass-treatment efforts, a key step toward WHO’s HCV elimination goals.

New research also explores extending its use in treating HCV patients with concurrent liver or kidney transplant, maintaining strong efficacy and safety.

Source: WHO Hepatitis C Treatment Guidelines

FAQ

What is Sofosbuvir 400mg + Velpatasvir 100mg used for?
This combination is used to treat chronic hepatitis C infections of all genotypes in both adults and children over 3 years old.

Is Sofosbuvir-Velpatasvir the same as Epclusa?
Yes, Epclusa is the brand name for the fixed-dose combination of Sofosbuvir 400mg and Velpatasvir 100mg.

What is the Epclusa cost without insurance?
Without insurance, the cost may exceed $24,000 for a 12-week course in the US. Generic versions are available at a fraction of the price.

How long do I need to take Sofosbuvir + Velpatasvir?
Typically, the treatment duration is 12 weeks. Your doctor may adjust this depending on your liver health and prior treatments.

Can I buy Sofosbuvir-Velpatasvir online?
Yes, generic versions are available through certified pharmacy platforms. Always ensure the source is licensed and verified.