Indication: Sofosvel is indicated for the treatment of chronic hepatitis C virus (HCV) infection in patients with or without cirrhosis, including those with compensated cirrhosis and those with advanced cirrhosis (decompensated).

Pharmacology: Sofosvel is a combination drug comprising two active ingredients: sofosbuvir and velpatasvir. Sofosbuvir is a nucleotide analog NS5B polymerase inhibitor, while velpatasvir is an NS5A inhibitor. Together, they work by interfering with the replication of the hepatitis C virus, ultimately suppressing its activity and allowing the body’s immune system to clear the infection.

Dosage and Administration: The recommended dosage of Sofosvel is one tablet (containing 400 mg of sofosbuvir and 100 mg of velpatasvir) taken orally once daily with or without food. It is essential to adhere to the prescribed dosage regimen and not to miss any doses.

Interactions:Sofosvel may interact with certain medications, including but not limited to:

– Anticonvulsants (e.g., carbamazepine, phenytoin)
– Rifampin
– St. John’s Wort
– HIV antiretrovirals (e.g., efavirenz, ritonavir)
– Certain acid-reducing agents (e.g., proton pump inhibitors)

It is crucial to inform healthcare providers about all medications, supplements, and herbal products being taken before starting Sofosvel to prevent potential drug interactions.

Side Effects: Common side effects of Sofosvel may include:

– Headache
– Fatigue
– Nausea
– Diarrhea
– Insomnia
– Rash
– Anemia

These side effects are usually mild and transient. However, if they persist or worsen, medical attention may be required.

Precautions and Warnings: Before initiating treatment with Sofosvel, healthcare providers should consider the following precautions and warnings:

 Risk of Hepatitis B Reactivation: Patients co-infected with hepatitis B virus (HBV) and HCV should be monitored closely for signs of HBV reactivation during and after treatment with Sofosvel.

 Pregnancy and Breastfeeding: Sofosvel should not be used during pregnancy due to potential fetal harm. Additionally, breastfeeding is not recommended during treatment with Sofosvel.
Renal Impairment: Dose adjustment is not required in patients with mild to moderate renal impairment. However, Sofosvel has not been studied in patients with severe renal impairment or end-stage renal disease.
Hepatic Impairment: Sofosvel can be used in patients with mild, moderate, or severe hepatic impairment, including those with decompensated cirrhosis. However, close monitoring is recommended in these patients.
Risk of Resistance: Treatment failure and development of resistance-associated substitutions may occur with Sofosvel. Resistance testing should be performed in patients who fail therapy.

Overdose Effect: There is limited information regarding overdose of Sofosvel. In case of suspected overdose, supportive measures should be initiated as necessary. Patients should seek immediate medical attention or contact a poison control center if an overdose is suspected.

Patients should always consult their healthcare provider for personalized recommendations and guidance regarding the use of Sofosvel for the treatment of chronic hepatitis C.