A hepatitis C antiviral
Velpatasvir
A hepatitis C antiviral combined with sofosbuvir (Epclusa) that cures all the main types of the infection.
What is Velpatasvir?
Velpatasvir is a direct-acting antiviral used to cure hepatitis C. It is given combined with sofosbuvir in a single tablet called Epclusa, taken as a short course lasting weeks. A key advantage is that it works against all the main types (genotypes) of hepatitis C, so it suits a wide range of people. It is usually well tolerated. Acid-lowering medicines, such as antacids and stomach-protecting drugs, reduce how much velpatasvir the body absorbs, so these need careful timing. It is prescribed and supervised by a specialist liver or infection team.
Education and reference only. This is a plain-language guide to Velpatasvir — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Velpatasvir is one of the direct-acting antivirals used to cure hepatitis C, a virus that infects the liver. It is combined with sofosbuvir in a single tablet called Epclusa, so the two medicines work together against the virus. A particular strength of this combination is that it treats all the main types of hepatitis C, which means people can often start it without first waiting to find out which type they have. Untreated, hepatitis C can lead over many years to liver scarring (cirrhosis) and liver cancer, but a short course now clears it in most people. It is started and overseen by a specialist liver or infectious-diseases team.
How it works
Velpatasvir blocks a protein the hepatitis C virus needs to copy itself and build new virus particles (called NS5A), and it does so across all the main strains of the virus. Its partner sofosbuvir blocks a different viral enzyme, so together they stop the virus reproducing from more than one direction. This broad, combined attack is highly effective and helps prevent resistance. Over the weeks of treatment the virus in the blood falls to undetectable levels, and a blood test after the course confirms whether it has been cleared for good.
Company & origin
Originated / developed by: Gilead Sciences.
A direct-acting antiviral developed for hepatitis C and used in the UK combined with sofosbuvir as the Epclusa tablet.
Practical use
How to take Velpatasvir
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the Epclusa tablet exactly as your specialist team directs, usually once a day, and complete the full course.
- Separate antacids from your dose by several hours, as they reduce how much velpatasvir your body absorbs.
- If you take a stomach-protecting medicine such as a proton pump inhibitor, follow your team's advice on timing or dose.
- Tell your team about every medicine, supplement and herbal remedy you take before you start.
- Attend your follow-up blood test after the course, as this confirms whether the virus has been cleared.
Weighing it up
Advantages & disadvantages of Velpatasvir
Advantages
- Works against all the main types of hepatitis C, so it suits a wide range of people.
- Combined with sofosbuvir in one tablet, it cures the great majority of people in a short course.
- Generally very well tolerated, with mostly mild side effects.
Disadvantages
- Acid-lowering medicines reduce how much is absorbed, so timing has to be managed carefully.
- Only available through specialist services and needs a follow-up test to confirm cure.
- Can interact with some other medicines, so the full medicine list must be reviewed.
Practical use
Good to know
Hepatitis C is now curable for the great majority of people, and the velpatasvir-with-sofosbuvir (Epclusa) course is widely used because it covers all the main virus types in one regimen. It is usually very well tolerated, with headache, tiredness and nausea the most common complaints. As with ledipasvir, velpatasvir needs a certain level of stomach acid to be absorbed well, so acid-lowering medicines reduce its effect: antacids should be spaced apart and stronger acid-suppressing drugs need careful timing or adjustment on your team's advice. Finishing the whole course and attending the follow-up test give the best chance of a cure.
Who should not take it / use with caution
- It is used with care in people who need regular acid-lowering medicines, which may have to be timed or adjusted.
- It is avoided alongside certain medicines (such as some epilepsy drugs, rifampicin and St John's wort) that stop it working.
- The combination is chosen carefully in advanced liver or kidney disease.
Monitoring
- A blood test some weeks after finishing to confirm the virus has been cleared.
- Checks on liver function and response during treatment.
- Review of acid-lowering and other medicines to manage absorption and interactions.
Side effects
- Headache, tiredness and nausea are the most common effects and are usually mild.
- Trouble sleeping or muscle aches in some people.
- Rarely, more troublesome effects that should be reported to your team.
Key interactions
- Antacids, and stomach-protecting drugs such as proton pump inhibitors, reduce how much velpatasvir is absorbed.
- Some epilepsy medicines, rifampicin and St John's wort can lower its levels and stop it working.
- It can affect certain heart and cholesterol medicines, so your team will review everything you take.
Available as: Tablets taken by mouth, as a fixed combination with sofosbuvir (Epclusa).
Answers
Velpatasvir: frequently asked questions
What is Epclusa?
Epclusa is the tablet that combines velpatasvir with sofosbuvir; the two antivirals work together to cure hepatitis C across all its main types.
Does it work for my type of hepatitis C?
A strength of this combination is that it treats all the main types of hepatitis C, so it suits a wide range of people.
Can I take antacids with it?
Antacids should be separated by several hours and stronger acid-lowering drugs may need adjusting, as they reduce how much velpatasvir your body absorbs; follow your team's advice.
Will it cure my infection?
The velpatasvir-and-sofosbuvir course cures the great majority of people; a blood test some weeks after the course confirms the virus has gone.
How long is the treatment?
The course usually lasts a number of weeks; your specialist team will tell you the exact length and it is important to finish it all.
The wider class
About Hepatitis C antiviral (NS5A inhibitor)
Velpatasvir belongs to the hepatitis c antiviral (ns5a inhibitor) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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