Sovaldi (sofosbuvir) is a direct-acting antiviral used to treat chronic hepatitis C virus (HCV) infection. It is a NS5B polymerase inhibitor that blocks a key enzyme the hepatitis C virus uses to copy its genetic material, stopping it from replicating.

Sofosbuvir is rarely used alone. It is the backbone of several combination regimens for hepatitis C, including:

• Sofosbuvir plus ribavirin (for genotypes 2 and 3)
• Sofosbuvir plus peginterferon and ribavirin (for some genotypes)

In Australia, sofosbuvir is now more commonly available as part of the combination tablets Epclusa (sofosbuvir/velpatasvir) and Harvoni (ledipasvir/sofosbuvir), which treat a broader range of genotypes and are generally more convenient.

Take one 400 mg tablet once daily, with or without food. Take at the same time each day.

Sovaldi is always used in combination with other medicines. Do not use it alone for hepatitis C treatment.

Treatment duration depends on the genotype and regimen: typically 12 to 24 weeks.

If you remember within 18 hours of your usual dose, take it as soon as possible and resume your schedule. If more than 18 hours have passed, skip the dose and continue as usual. Never take two doses at once.

Contact your doctor or a poison control centre.

• Store below 30°C
• Keep in the original packaging
• Keep out of reach of children

Side effects of Sovaldi are related to the sofosbuvir component and depend on the combination regimen used.

When used with ribavirin:

• Fatigue
• Headache
• Nausea
• Anaemia (ribavirin causes haemolytic anaemia, reducing red blood cells)
• Insomnia
  
  

When used with peginterferon and ribavirin:

• Flu-like symptoms
• Mood changes (interferon can cause depression)
• Low blood counts
  
  

Your doctor will check blood counts and liver function during treatment. If you are using ribavirin, regular haemoglobin monitoring is essential.

• Amiodarone: when combined with sofosbuvir, can cause serious slowing of the heart rate. This combination requires close monitoring or avoidance
• Rifampicin, carbamazepine, phenytoin, phenobarbital, St John's Wort: significantly reduce sofosbuvir levels. Avoid
• P-glycoprotein inhibitors (ciclosporin): may increase sofosbuvir exposure
  
  

Always tell all your doctors you are taking Sovaldi before starting any new medicine.

Can Sovaldi cure hepatitis C on its own?

No. Sofosbuvir alone is not effective enough to cure hepatitis C. It must always be combined with at least one other direct-acting antiviral or with ribavirin. The high cure rates achieved with sofosbuvir-based regimens come from the combination of medicines working together to block multiple steps of the virus's replication cycle.

What is a sustained virological response?

A sustained virological response (SVR) means that no hepatitis C virus can be detected in your blood 12 weeks after completing treatment. SVR is considered a cure: for the vast majority of people, the virus does not return after achieving SVR. However, you can be re-infected with hepatitis C in the future if exposed again.

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.