Are there any side effects of sofosbuvir and velpatasvir (Epclusa)? Is it serious?

Sofosbuvir and velpatasvir (Epclusa) is a pan-genotypic NS5A-NS5B inhibitor single-agent combination regimen with potent activity against hepatitis C virus (HCV) genotypes 1, 2, 3, 4, 5 and 6. All-grade adverse reactions including headache, fatigue, nausea, asthenia, and insomnia were observed in greater than or equal to 5% of subjects treated with sofosbuvir and velpatasvir. The most common adverse reactions (all grades with a frequency of 10% or greater) in febrile subjects receiving sofosbuvir, velpatasvir and ribavirin were fatigue, anemia, nausea, headache, insomnia, and diarrhea.

There is no specific antidote for overdose of sofosbuvir and velpatasvir combination. In the event of overdose, the patient must be monitored for signs of toxicity. Treatment of sofosbuvir and velpatasvir overdose includes general supportive measures, including monitoring of vital signs and observation of the patient's clinical status. Hemodialysis can effectively remove sofosbuvir's main circulating metaboliteGS-331007, with an extraction rate of 53%. Hemodialysis is unlikely to result in significant clearance of velpatasvir because velpatasvir is highly bound to plasma proteins.

The original drug of sofosbuvir and velpatasvir has been launched in China and has entered the scope of Class B medical insurance. The domestic trade name is protonsa, and the specification is (400mg+100mg) * 28 tablets. The price per box is about RMB 4,000. The original drug of sofosbuvir and velpatasvir has also been launched overseas. There are also generic drugs of sofosbuvir and velpatasvir produced in other countries. The specifications of the Bangladesh Everest Pharmaceutical Factory are (400mg + 100mg) * 28 tablets per box, and the price is around RMB 850 (the price may fluctuate due to the exchange rate). The generic drugs produced abroad are basically the same as the original drugs at home and abroad.