Starting Your Hep C Treatment with Epclusa
Last updated: February 2023
Epclusa is a direct-acting antiviral that treats hepatitis C infection. It is a combination of 2 ingredients: sofosbuvir and velpatasvir. Over 90% of people are able to achieve a cure, also called a sustained virologic response (SVR), after therapy. The following will help break down what to expect before and during treatment.1
Labs prior to starting treatment
To ensure that Epclusa will be safe and effective, your clinician will order blood tests within 6 months of starting treatment. In addition to a viral load test, other baseline tests may include:2
- Complete Blood Count (CBC) - This test measures your total red blood cells, white blood cells, and platelets.
- International Normalized Ratio (INR) - INR determine how fast your body can form blood clots. The liver produces the necessary proteins to help the blood to clot. If the INR is high, that could mean that the liver is not working as well as it should.
- Hepatic Function Panel - This includes a variety of tests, such as albumin, total and direct bilirubin, ALT, AST, and alkaline phosphatases. These collectively paint a picture of how well your liver is working.
- Glomerular Filtration Rate (GFR) - GFR is an estimation of how well your kidney is working. Sometimes, people with Hepatitis C also have kidney disease; it is therefore important to rule out kidney disease before starting treatment.
- Hepatitis B surface antigen and core antibody test - These detect whether you have an active hepatitis B infection. Some people who are co-infected may have a reactivation of the hepatitis B virus during treatment. This can lead to severe liver complications during treatment, but can be mitigated by monitoring the liver more frequently.
Other medications and Epclusa
Epclusa has many drug interactions, including some over-the-counter products. Be sure to let your doctor know of all the medications you take, including herbals and vitamins. Some of these interactions can be serious, and others may decrease effectiveness of Epclusa.1
Unfortunately, very few drugs come with no side effects. It is important to be knowledgable of these potential side effects and let your team know if they occur. Possible side effects include headaches, diarrhea, nausea, trouble sleeping, and fatigue.1 Connecting with others with hepatitis C and learning how others manage their side effects can help validate your feelings and symptoms.
How should you take Epclusa
Epclusa is typically prescribed as a once daily tablet taken for 12 consecutive weeks. In addition, some people are also prescribed ribavirin in conjunction to Epclusa. Epclusa can be taken with or without food.1
Plan on taking this medication until the total duration of therapy is over, even if you feel well before your therapy is over. In addition, do not miss or skip a day -- try to take it at the same time daily. If you miss a dose, take it as soon as you remember, but never take more than 1 dose in a day. If you remember at a time close to your scheduled dose, then skip the missed dose, and continue with your original schedule.
Starting a new medication can be stressful experience. By equipping yourself with knowledge and a support system, you will have a better understanding of what to expect during treatment.