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Harvoni

Generic Name: ledipasvir and sofosbuvir (le DIP as vir and soe FOS bue vir)
Brand Names: Harvoni
Harvoni (ledipasvir and sofosbuvir) is used to treat Hepatitis C. Includes Harvoni side effects, interactions and indications.
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Drug Information:
Harvoni contains a combination of ledipasvir and sofosbuvir. Ledipasvir and sofosbuvir are antiviral medications that prevent the hepatitis C virus (HCV) from multiplying in your body. Harvoni is used to treat chronic hepatitis C in adults and children who are at least 12 years old or who weigh at least 77 pounds (35 kilograms). Ledipasvir and sofosbuvir is sometimes given in combination with another medicine called Ribavirin. Harvoni treats specific genotypes of hepatitis C, and only in certain people. Use only the medications prescribed for you. Do not share your medicine with other people. Learn more

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Harvoni Side Effects

Note: This document contains side effect information about ledipasvir / sofosbuvir. Some of the dosage forms listed on this page may not apply to the brand name Harvoni.

For the Consumer

Applies to ledipasvir / sofosbuvir: oral tablet

Warning

Oral route (Tablet)

Test all patients for evidence of current or prior hepatitis B virus (HBV) infection before initiating treatment with ledipasvir / sofosbuvir. HBV reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct acting antivirals and were not receiving HBV antiviral therapy. Some cases have resulted in fulminant hepatitis, hepatic failure, and death. Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV treatment and post-treatment follow-up. Initiate appropriate patient management for HBV infection as clinically indicated.

Along with its needed effects, ledipasvir / sofosbuvir may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ledipasvir / sofosbuvir:

Incidence not known

  • Chest pain or discomfort
  • lightheadedness, dizziness, or fainting
  • slow or irregular heartbeat
  • trouble breathing
  • unusual tiredness

Some side effects of ledipasvir / sofosbuvir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Cough
  • diarrhea
  • headache
  • irritability
  • lack or loss of strength
  • muscle pain
  • nausea
  • trouble sleeping

Less common

  • Discouragement
  • dizziness
  • feeling sad or empty
  • lack of appetite
  • loss of interest or pleasure
  • trouble concentrating

For Healthcare Professionals

Applies to ledipasvir / sofosbuvir: oral tablet

General

The most common side effects reported with this drug were fatigue, headache, asthenia, and nausea. When this drug was studied with ribavirin, the most common side effects to this combination were consistent with known ribavirin side effects; frequency and severity of the expected side effects were not increased. Therapy was permanently discontinued due to side effects in 0%, less than 1%, and 1% of patients using this drug for 8, 12, and 24 weeks, respectively, and less than 1%, 0%, and 2% for patients using this drug with ribavirin for 8, 12, and 24 weeks, respectively.

Among 174 liver transplant recipients with compensated liver disease using this drug with ribavirin for 12 weeks, 1% permanently discontinued this drug due to a side effect.

Among 162 patients with decompensated liver disease (pretransplant or posttransplant) using this drug with ribavirin for 12 weeks, 4% died, 2% had a liver transplantation, and less than 1% had a liver transplantation and died during therapy or within 30 days after stopping therapy. Due to the advanced liver disease in these patients (who had increased risk of disease progression leading to liver failure and death), the contribution of drug effect to outcomes could not be reliably assessed. This drug was permanently discontinued due to a side effect in 2% of patients.

If this drug is used with ribavirin, the manufacturer product information for ribavirin should be consulted for associated side effects.

Hematologic

Decreased hemoglobin (less than 10 g/dL: up to 39%; less than 8.5 g/dL: up to 13%) has been reported in liver transplant recipients and/or patients with decompensated liver disease using this drug with ribavirin for 12 or 24 weeks. Ribavirin was permanently discontinued in up to 19% of patients. Immunosuppressive agents were modified in up to 10% of liver transplant recipients (modified dose due to improved organ function in at least 7%).

Very common (10% or more): Decreased hemoglobin (up to 39%)

Other

Very common (10% or more): Asthenia (up to 36%), fatigue (up to 18%)

Nervous system

Very common (10% or more): Headache (up to 29%)

Common (1% to 10%): Dizziness

Respiratory

Very common (10% or more): Cough (up to 11%)

Common (1% to 10%): Dyspnea

Gastrointestinal

Common (1% to 10%): Nausea, diarrhea, increased lipase

Increased lipase (greater than 3 times the upper limit of normal [3 x ULN]) was reported in less than 1%, 2%, and 3% of patients using this drug for 8, 12, and 24 weeks, respectively. Increased lipase (greater than 3 x ULN) was reported in 1%, 3%, and 9% of patients with compensated cirrhosis using placebo, this drug plus ribavirin for 12 weeks, and this drug for 24 weeks, respectively. Lipase elevation was transient and asymptomatic.

Psychiatric

Depression (especially in patients with history of psychiatric illness) was reported in patients using sofosbuvir-containing regimens. Suicidal ideation and suicide have been reported in less than 1% of patients using sofosbuvir with ribavirin or pegylated interferon/ribavirin in other clinical trials.

Common (1% to 10%): Insomnia, irritability

Frequency not reported: Depression

Sofosbuvir:

-Frequency not reported: Depression, suicidal ideation, suicide

Dermatologic

Common (1% to 10%): Rash

Postmarketing reports: Skin rashes (sometimes with blisters or angioedema-like swelling), angioedema

Hepatic

Increased bilirubin (greater than 1.5 x ULN) was reported in 3%, less than 1%, and 2% of patients using this drug for 8, 12, and 24 weeks, respectively. Increased bilirubin (greater than 1.5 x ULN) was reported in 3%, 11%, and 3% of patients with compensated cirrhosis using placebo, this drug plus ribavirin for 12 weeks, and this drug for 24 weeks, respectively.

Common (1% to 10%): Increased bilirubin

Postmarketing reports: Hepatitis B reactivation

Cardiovascular

Frequency not reported: Severe bradycardia, heart block

Postmarketing reports: Serious symptomatic bradycardia (including fatal cardiac arrest, cases requiring pacemaker intervention)

Severe bradycardia and heart block have been reported when this drug was used with concomitant amiodarone and/or other agents that lower heart rate.

Serious symptomatic bradycardia has been reported in patients taking amiodarone who started therapy with this drug.

Musculoskeletal

Common (1% to 10%): Myalgia, elevated creatine kinase

Sofosbuvir:

-Frequency not reported: Elevated creatine kinase

Creatine kinase was not evaluated in some phase 3 clinical trials for this drug, but was evaluated in at least 1 trial. Isolated, asymptomatic creatine kinase elevations (at least 10 x ULN) were reported in 1% of patients using this drug for 12 weeks; such elevations were previously reported in patients using sofosbuvir with ribavirin or peginterferon/ribavirin in other clinical trials.

Editorial References and Review

Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.

Source: Drugs.com Harvoni (www.drugs.com/harvoni.html).