Skip to content
left end
left end
right end
*

Treatment

Direct acting antivirals (DAAs) are the most effective treatment option for people with hepatitis C and are the NICE and NHS England recommended medications.

  • Choice of DAA is dependent on the type of hepatitis c virus you have (genotype), past treatment response, the level of active virus in your body (viral load) and if there is cirrhosis (degree of liver damage shown by scarring of the liver).
  • Ribavirin may be added to the treatment when patients have a high viral load or more advanced liver disease, to increase the chance of achieving a cure.
  • Drug interactions are very important to consider in people receiving DAA therapy, as they can sometimes affect how well the treatment works (eg oral contraceptives) or contribute to side effects. It is essential that all co-prescribed medication is first checked for drug to drug interactions using https://www.hep-druginteractions.org/.
  • DAAs and ribavirin cannot be prescribed safely during pregnancy and some drugs can affect conception also. These risks will be discussed with patients prior to starting treatment.

 

Common Medications

Elbasvir/Grazoprevir 50mg/100mg (Zepatier®)

  • Zepatier is a two-drug combination in a single tablet. It is 1 tablet taken orally and swallowed whole once daily. Treatment durations are 12 or 16 weeks depending on viral load and genotype.
  • Side effects are minimal but some people experience headache, nausea, diarrhoea, insomnia and fatigue (lack of energy).
  • This drug may not be suitable if you are taking anticoagulants (such as rivaroxaban or apixaban), epilepsy medications or some cholesterol-lowering drugs (statins) but people will be assessed on an individual basis.

Glecaprevir/Pibrentasvir 100mg/40mg (Maviret®)

  • Maviret is a two-drug combination in a single tablet. It is 3 tablets taken orally and swallowed whole with food once a day. Treatment duration is usually 8 weeks; courses up to 16 weeks are needed occasionally.
  • Side effects are minimal but some people experience headache, nausea and fatigue (lack of energy).
  • This drug may not be suitable if you are taking anticoagulants (such as rivaroxaban or apixaban), epilepsy medications or some cholesterol lowering drugs (statins) but people will be assessed on an individual basis.

Sofosbuvir/Ledipasvir 400mg/90mg (Harvoni®)

  • Harvoni is a two-drug combination in a single tablet. It is 1 tablet taken orally and swallowed whole once a day. Treatment durations are 8 or 12 weeks depending on viral load, genotype and past treatment response.
  • Side effects are minimal but some people experience headaches and fatigue (lack of energy).
  • This drug may not be suitable if you are taking amiodarone, anticoagulants (such as rivaroxaban or apixaban), epilepsy medications or some cholesterol lowering drugs but people will be assessed on an individual basis. If you have problems with your kidneys this drug may not be suitable.

Sofosbuvir/Velpatasvir 400mg/100mg (Epclusa®)

  • Epclusa is a two-drug combination in a single tablet. It is 1 tablet taken orally and swallowed whole once a day. Treatment duration is usually 12 weeks depending on viral load, genotype and past treatment response.
  • Side effects are minimal but some people experience headaches and fatigue (lack of energy).
  • This drug may not be suitable if you are taking amiodarone, anticoagulants (such as rivaroxaban or apixaban), epilepsy medications or some cholesterol lowering drugs (statins) but people will be assessed on an individual basis. If you have problems with your kidneys this drug may not be suitable.

Ribavirin

  • Ribavirin alone does not cure hepatitis C but is used in combination with other DAAs to increase their effect. The number of tablets taken depends on weight and kidney function, and the number of tablets taken can change during treatment.
  • Side effects include fatigue (lack of energy), insomnia and headache.
  • This drug may not be suitable if you have heart problems or some blood disorders or azathioprine. Ribavirin can cause birth defects in animals and will not be prescribed.