What is Velpatasvir?


Velpatasvir is an antiviral medication used in the treatment of hepatitis C virus (HCV) infection. It belongs to the class of drugs known as direct-acting antivirals (DAAs) and functions as an HCV NS5A inhibitor. Velpatasvir is commonly used in combination with sofosbuvir, another antiviral agent, in a fixed-dose combination pill marketed under the brand name Epclusa. This combination is effective against all major genotypes of HCV, making it a pan-genotypic treatment option.

Mechanism of Action

Velpatasvir works by inhibiting the NS5A protein, a critical component of the HCV replication complex. By blocking NS5A, velpatasvir disrupts viral RNA replication and virion assembly, thereby reducing the viral load in the body. When used with sofosbuvir, which inhibits the HCV RNA polymerase, the combination provides a powerful and comprehensive approach to halting the replication of hepatitis C virus.

Uses of Velpatasvir

Velpatasvir, in combination with sofosbuvir, is used to treat chronic hepatitis C infection in adults and certain pediatric patients. The combination is effective against HCV genotypes 1 through 6, making it suitable for a wide range of patients regardless of their specific HCV genotype. Epclusa is used both in patients with and without cirrhosis and has shown high cure rates in clinical trials.

Approval and Availability

Velpatasvir/sofosbuvir (Epclusa) was approved by the US Food and Drug Administration (FDA) in June 2016. It has since been approved in many other countries around the world. Epclusa is notable for its pan-genotypic efficacy, which simplifies the treatment regimen for chronic hepatitis C by providing a single solution for multiple HCV genotypes.

Side Effects of Velpatasvir

The most common side effects of velpatasvir/sofosbuvir include headache, fatigue, nausea, and insomnia. While generally well-tolerated, some patients may experience more severe side effects, such as bradycardia (slow heart rate) when taken with certain heart medications like amiodarone. It is essential for patients to inform their healthcare providers about their complete medical history and current medications to avoid potential adverse interactions.