Hepatitis Hepatitis C Taking Harvoni (ledipasvir/sofosbuvir) for Hepatitis C By James Myhre & Dennis Sifris, MD Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator. Learn about our editorial process James Myhre & Dennis Sifris, MD Medically reviewed by Medically reviewed by Priyanka Chugh, MD on March 24, 2020 linkedin Priyanka Chugh, MD, is a board-certified gastroenterologist and Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai. Learn about our Medical Review Board Priyanka Chugh, MD on March 24, 2020 Print Hepatitis C Overview Symptoms Causes Diagnosis Treatment Coping Prevention Gilead Science Harvoni is a fixed dose combination drug used in the treatment of chronic hepatitis C (HCV) infection. The two drugs that comprise Harvoni (ledipasvir, sofosbuvir) work by blocking both a protein (NS5A) and an enzyme (RNA polymerase) vital to the replication of the virus. Harvoni was approved in October 10, 2014, by the U.S. Food and Drug Administration (FDA) for use in adults 18 years or over with HCV genotypes 1 infection, including those with cirrhosis. Harvoni is approved for use in previously untreated ("treatment-naïve") patients, as well as those with partial or no response to prior HCV therapy ("treatment-experienced"). Harvoni is the first FDA-approved HCV drug that does not need to be taken with either pegylated interferon (peg-interferon) or ribavirin (two drugs traditionally used for HCV combination therapy, both of which had high toxicity profiles). Harvoni is reported to have cure rates of between 94% and 99%, while Phase II trials have reported a 100% cure rate in patients coinfected with HIV and HCV. Dosage One tablet (90mg/400mg) taken daily with or without food. Harvoni tablets are diamond-shaped, ginger-colored, and film-coated, with "GSI" embossed on one side and "7985" on the other. Prescribing Recommendations Harvoni is prescribed over a 12- to 24-week course, as per the following recommendations: Treatment-naïve with or without cirrhosis: 12 weeksTreatment-experienced without cirrhosis: 12 weeksTreatment-experienced with cirrhosis: 24 weeks Additionally, an 8-week course can be considered for treatment-naïve patients without cirrhosis who have an HCV viral load of under 6 million copies/mL. Common Side Effects The most common side effects associated with the use of Harvoni (occurring in 10% or less of patients) are: FatigueHeadache Other possible side effects (under 10%) include nausea, diarrhea, and insomnia. Drug Interactions The following should also be avoided when using Harvoni: Rifampin-based anti-tuberculosis medications: Mycobutin, Rifater, Rifamate, Rimactane, Rifadin, PriftinAnticonvulsants: Tegretol, Dilantin, Trileptal, phenobarbitalAptivus (tipranavir/ritonavir) used in HIV antiretroviral therapySt. John's Wort Contraindications and Considerations There are no contraindications for the use of Harvoni in patients with HCV genotype 1. However, for patients with HIV using the drug tenofovir (including Viread, Truvada, Atripla, Complera, Stribild), extra care should be given in monitoring for any tenofovir-associated side effects, particularly renal (kidney) impairment. Antacids should be taken separately 4 hours before or after a Harvoni dose, while dosages of proton pump inhibitors and H2 receptor inhibitors (a.k.a. H2 blockers) may need to be reduced in order to prevent decreasing ledipasvir absorption. While there is no contraindication for the use of Harvoni in pregnancy, little human clinical data is available. However, animal studies into the use of both ledipasvir and sofosbuvir have shown no effect to fetal development. Specialist consultation is recommended during pregnancy to assess the urgency of Harvoni therapy, specifically whether to start immediately or to wait until after delivery. It is recommended that all women of child-bearing age be monitored monthly for pregnancy during the course of therapy. It is also recommended that the patient and her male partner be provided at least two non-hormonal methods of contraception and that they be used during the course of therapy and for six months afterward. Hepatitis C Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. Food and Drug Administration (FDA). "FDA approves first combination drug to treat hepatitis C." Silver Spring, Maryland; press release issued October 10, 2014.