Epclusa combines two antiviral medicines, sofosbuvir and velpatasvir, to treat chronic hepatitis C virus (HCV) infection. It is a pan-genotypic treatment, meaning it works against all six main types (genotypes) of hepatitis C.

For most people without advanced liver disease, a 12-week course of Epclusa results in a sustained virologic response (SVR), which means the hepatitis C virus is no longer detectable in the blood after treatment ends. This is effectively a cure for hepatitis C.

How it works:

Hepatitis C is a virus that infects the liver and can cause long-term damage if untreated. Sofosbuvir blocks an enzyme called NS5B polymerase that the virus uses to replicate, while velpatasvir blocks another viral protein called NS5A, which is essential for the virus to assemble and spread. Together, they attack the virus on two fronts, making it very difficult for hepatitis C to replicate.

Your dose:

One tablet taken once daily for 12 weeks. Your doctor may recommend a longer course or add ribavirin if you have advanced liver disease (cirrhosis). Always follow your doctor's instructions.

How to take it:

• Take Epclusa at the same time every day
• It can be taken with or without food
• Swallow the tablet whole
  

Before you start:

• Tell your doctor about all medicines, vitamins, and supplements you take. Epclusa has several important interactions
• Let your doctor know if you have kidney or liver problems, including whether you have cirrhosis
• If you have hepatitis B as well as hepatitis C, tell your doctor before starting, as treating hepatitis C can cause hepatitis B to reactivate

• If you remember within 18 hours of your usual dose: take the tablet as soon as possible, then continue your regular schedule
• If more than 18 hours have passed: skip the missed dose and take your next one at the usual time
• Never take two tablets at once
  

Completing the full course is essential for achieving a cure. Try not to miss doses.

If you think you have taken more than prescribed, call 000 or go to your nearest emergency department. Bring your medicine packet.

• Store below 30°C
• Keep in the original packaging to protect from moisture
• Keep out of reach of children and pets

Epclusa is generally very well tolerated.

Most people complete the 12-week course with only mild side effects, if any.

• Headache: The most commonly reported side effect
• Fatigue: Some people feel more tired during treatment
• Nausea: Usually mild and temporary
• Insomnia: Some people have difficulty sleeping during treatment

If you are also taking ribavirin alongside Epclusa, you may experience additional side effects including anaemia, rash, and irritability.

Contact your doctor or pharmacist if any side effect concerns you.

Epclusa has several important interactions.

Tell your doctor and pharmacist everything you are taking before starting.

Key interactions include:

• Rifampicin, carbamazepine, phenytoin, and St John's Wort: These reduce Epclusa's effectiveness significantly and must not be used together
• Amiodarone (a heart medicine): Can cause serious heart rhythm problems when combined with sofosbuvir. Tell your doctor if you take amiodarone
• Antacids: Separate antacids containing aluminium or magnesium by at least 4 hours from Epclusa
• HIV antiretroviral medicines: Some HIV medicines interact with Epclusa. Your doctor will check for these

Never start, stop, or change any medicine without speaking to your doctor first.

Can hepatitis C really be cured?

Yes. Modern direct-acting antivirals like Epclusa have cure rates above 95% for most people. A sustained virologic response (no detectable virus 12 weeks after completing treatment) is considered a cure. This means the virus is gone from your body, your liver can begin to recover, and you are no longer at risk of transmitting the virus to others through blood-to-blood contact.

Do I need to be tested after finishing treatment?

Yes. Your doctor will arrange a blood test approximately 12 weeks after you finish your course of Epclusa to confirm that the virus is undetectable. This confirms that you have been cured. You should also have ongoing monitoring of your liver health, as any existing liver damage does not reverse immediately.

Will I be cured for life?

If you achieve a sustained virologic response, the hepatitis C virus is cleared from your body and you will not relapse. However, you can be re-infected with hepatitis C if you are exposed to the virus again in the future. Reducing risk behaviours (such as not sharing needles or other equipment) remains important.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.