Hepatitis C drug treatment
There are a number of drug treatments for hepatitis C available from the NHS. Hepatitis C is treated using direct-acting antiviral (DAA) tablets.
Your specialist care team will recommend a course of treatment depending on your health, medical history, your wishes and the genotype (variation) of the virus.
We have outlined the treatments available from the NHS below. Speak to your specialist care team about any concerns or questions you have about your treatment.
Epclusa is used to treat chronic hepatitis C in adults with all genotypes.
It is a two-drug combination pill containing Velpatasvir and Sofosbuvir.
Epclusa is an antiviral medication that targets the hepatitis C virus. Epclusa works by preventing the virus from copying itself. If the virus cannot copy and spread, it eventually dies.
It is used on its own in patients without cirrhosis or with compensated cirrhosis and in combination with ribavirin in patients with decompensated cirrhosis.
To make sure Epclusa is safe for you, tell your doctor if you have:
- A history of hepatitis B
- Kidney disease
- Liver problems other than hepatitis
- HIV
- If you have recently used a heart rhythm medicine called amiodarone (Cordarone, Pacerone).
Epclusa is a tablet taken once a day with or without food.
Treatment will last for 12 weeks.
The most common side effects are fatigue and headache.
Glecaprevir and pibrentasvir (also known as Maviret) is a two-drug combination tablet.
Glecaprevir and pibrentasvir stop replication of the hepatitis C viruses by directly affecting the mechanisms used by the virus to make copies of itself.
You should take three tablets once a day with food.
Treatment will last for between 8 and 16 weeks.
The most common side effects are: headache, fatigue and nausea.
Harvoni is an antiviral medicine used to treat chronic hepatitis C. It contains the active substances sofosbuvir and ledipasvir.
Harvoni has been approved within the NHS for treatment of Genotype 1. It has also been approved for people with Genotype 4 who have previously had treatment or who have compensated cirrhosis.
Sofosbuvir and ledipasvir stop replication of the hepatitis C viruses by directly affecting the mechanisms used by the virus to make copies of itself. If the virus cannot copy and spread, it eventually dies.
Harvoni is a tablet taken once a day with or without food.
Treatment will last between 8 and 24 weeks.
The most common side effects are fatigue and headache.
Vosevi is a fixed dose combination of sofosbuvir, velapatasvir and voxilaprevir. It is recommended for adults who have already received other hepatitis C treatments which have not worked.
Sofosbuvir works by decreasing the amount of hepatitis C virus in the body. Velpatasvir blocks a protein that the hepatitis C virus needs to multiply. Voxilaprevir is a protease inhibitor. It works by decreasing the amount of the hepatitis C virus in the body.
The most common side effects are headache, fatigue, diarrhoea and nausea.
Vosevi is a tablet taken once a day.
Treatment will last for 8 to 12 weeks.
Zepatier is a two-drug combination administered with or without ribavirin as a single daily pill containing Elbasvir and Grazoprevir.
The active substances in the medicine work together by blocking two different proteins (NS5A and NS3/4A) that the hepatitis C virus needs to grow and reproduce. This allows the infection to be permanently removed from the body.
The most common side effects are headache and fatigue.
Zepatier is a tablet taken once a day with or without food.
Treatment will last between 12 and 16 weeks depending on the genotype and how much virus is in the blood (viral load).
Ribavirin is used to treat hepatitis C in combination with other medication. It is not effective on its own and should always be taken with another anti-hepatitis C treatment.
Ribavirin inhibits viral growth, has anti-viral properties and interrupts the way the hepatitis C virus absorbs genetic material when it replicates.
Ribavirin is not suitable to take if:
- You are pregnant or plan to be pregnant
- You are breastfeeding
- You have problems with your heart
- You have a blood disorder
- You have HIV
Ribavirin is known to harm the development of unborn children. It is important that you take precautions to prevent pregnancy with effective contraception whilst taking Ribavirin.
The number of ribavirin tablets needed per day will be calculated by your doctor.
You should take the daily dose in two divided doses, ideally 12 hours apart. Tablets should be taken with food.
Pegylated interferon used to be available to treat hepatitis C.
Although effective at curing the virus in around half of people, it often had serious side effects and had a negative effect upon the person’s quality of life while going through treatment.
People who were being treated with pegylated interferon had to take a weekly injection as well as a ribavirin tablet every day.
Since pegylated interferon was first prescribed, we have seen amazing advances in modern medicine which has made treatment much easier and more successful.
The NHS no longer offers pegylated interferon as a treatment.
If you tried pegylated interferon in the past and it did not work for you, you should speak to your doctor about trying a new treatment. New treatments require an 8-12 week course of tablets, have few side effects and are effective in 97% of people.