What to Know About Treating Hepatitis C With Harvoni

Ledipasvir-sofosbuvir (Harvoni) is an antiviral medication that attacks the hepatitis C virus. It's one of the most effective treatments for hep C.

How Does Harvoni Work?

Hepatitis means inflamed liver. After 6 months, it’s called “chronic” and in some cases may eventually lead to heavy scarring of the liver (cirrhosis). The hepatitis C virus spreads most commonly through needles shared by drug users, but sexual contact can also pass it on.

Harvoni is a combination of two drugs. Each one blocks a protein that the hep c virus needs in order to grow:

  • Ledipasvir blocks a protein called NS5A.
  • Sofosbuvir blocks an enzyme called NS5B RNA-dependent RNA polymerase.

Who Can Take It

Hepatitis C has six different genotypes. Each genotype has different genetic material, and some respond to medicine better than others. In the U.S., genotype 1 is the most common. It makes up about 75% of all U.S. cases.

The FDA approved Harvoni to treat hepatitis C genotypes 1, 4, 5, and 6 in adults and children.

Your doctor can also prescribe it if you have hep C along with:

  • HIV
  • Uncontrolled cirrhosis (if you have only genotype 1)
  • A liver transplant (if you have genotype 1 or 4)

How You Take It

Harvoni is a pill you take once a day for 2 to 6 months. How long you'll take it depends on how much of the virus is in your blood (your doctor might call it your viral load), as well as:

  • Your health history
  • Which hep C treatments you've taken
  • Other health issues you have (like cirrhosis)

Talk to your doctor if you have any questions about how to take your medications.

Is Harvoni a Cure for Hepatitis C?

The word “cure” has a very specific meaning for hepatitis C. It means there is no virus in your blood 12 weeks after your treatment is over. The cure rate for Harvoni is 94% to 99% when you don’t have other serious illnesses.

Harvoni might not work as well if:

  • You have advanced liver disease.
  • Your liver has some scarring (fibrosis).
  • You’ve had treatment for hep C before and it didn't work.
  • You don’t take your pills as prescribed.

In many cases, your doctor can adjust your dose and length of your treatment if Harvoni isn't working well for you. In some treatment plans, Harvoni may team with another drug called ribavirin (Moderiba).

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Risks and Side Effects

The majority of those who take Harvoni don’t have side effects. But some people have headaches or get more tired than usual.

Other rare side effects include:

Tell your doctor if you have hepatitis B because it can flare up or reactivate if you take Harvoni. They'll likely test you for this before you start on the drug. Tell your doctor about any medications you take because they could affect how well Harvoni works for you and even if it's safe for you to take. For example, the heart medication amiodarone (Pacerone, Cordarone) may not work well with it.

Cost

Harvoni is expensive. The wholesale price is about $1,100 per pill.

Your cost may be more or less, depending on whether you have insurance and what type you have. Check with your provider to be sure.

If your insurance doesn't cover your prescription, there are groups that may be able to provide Harvoni for little or no charge. Other discounts may also apply. So be sure to talk with your pharmacist and doctor about it.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on May 30, 2020

Sources

SOURCES:

CDC: “Hepatitis C Questions and Answers for the Public.”

Infohep.org: “Hepatitis C treatment factsheet: Harvoni (sofosbuvir + ledipasvir).”

Hepatitis C Online: “Ledipasvir-Sofosbuvir (Harvoni).”

Merck Manual: “Overview of Chronic Hepatitis.”

The Hepatitis Trust: “Harvoni.”

Treatment Action Group: “Harvoni Fact Sheet.”

University of Maryland School of Pharmacy: “Transferability of Economic Evaluation Studies: Is There a Generally Accepted Alternative Price Benchmark to the Wac Price?”

Hepatitis C Online: "Ledipasvir-Sofosbuvir (Harvoni)."

U.S. Department of Veterans Affairs: “Viral Hepatitis and Liver Disease.”

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