Antiviral

Recently Answered

• QWhat are the possible side effects of Harvoni?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Harvoni (ledipasvir and sofosbuvir) appears to have few side effects. In clinical trials, the most common adverse reactions were fatigue and headache. Some people also reported nausea, diarrhea and insomnia. Fewer than 1% of people stopped taking Harvoni because of these problems. However, Harvoni can interact with other medications, and in some cases this can worsen the side effects caused by those drugs. For example, Harvoni can raise the levels of rosuvastatin (Crestor) in the blood, increasing the risk of muscle pain and damage. This, in turn, can lead to liver and kidney problems.

  While you are taking Harvoni, if you develop any side effects that concern you or don't go away, be sure to tell your doctor. 

• QWhat is Viekira Pak?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Viekira Pak is a treatment for hepatitis C approved by the FDA late in 2014. Viekira Pak consists of four different oral medications: ombitasvir, paritaprevir, dasabuvir and ritonavir. The first three work in various ways to attack the hepatitis C virus and stop it from multiplying; ritonavir is included because it increases the action of one of the other drugs. Viekira Pak may be prescribed with or without another hepatitis C drug, ribavirin. 

  Viekira Pak is approved to treat hepatitis C in people who are infected with a particular type of the virus, called genotype 1. This is the most common type of hepatitis C in the U.S. It is effective in people who already have some scarring (cirrhosis) of the liver, but not in those who have "decompensated cirrhosis," meaning the liver no longer is able to function normally. 

  In clinical trials, 91% of people who took Viekira Pak at the recommended dosage for 12 weeks no longer had detectable hepatitis C virus in their blood. This is considered a cure.

• QWhat is Harvoni?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Harvoni (ledipasvir and sofosbuvir) is a medication used to treat chronic hepatitis C infection, specifically caused by subtypes of the virus called genotypes 1, 4, 5 and 6. Harvoni is the first hepatits C medication to combine two drugs into the same pill. It's also the first hepatitis C treatment approved for use without interferon and ribavirin, two drugs that had long been a standard treatment for the infection. Both drugs in Harvoni stop the virus from multiplying, but in different ways. Sofosbuvir is also sold as Sovaldi, and is commonly used with other drugs to treat hepatitis C.

  In clinical trials done prior to approval, 94% of those who took Harvoni for eight weeks and 96% of those who took it for 12 weeks were considered cured, because the virus was no longer detectable in their blood. Among people who didn't have cirrhosis (scarring) of the liver caused by the infection, 99% were cured after 12 weeks. The most common side effects were fatigue and headache. Harvoni is typically taken once a day with or without food, for eight to 24 weeks.

• QWhat should I know about Harvoni before taking it?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Clinical trials suggest that Harvoni (ledipasvir and sofosbuvir) is a remarkably safe drug. The only side effects reported were fatigue, headache, stomach upset and trouble sleeping. Harvoni has no contraindications, meaning doctors haven't found the drug to be unsafe for any groups of people. The safety and effectiveness for children under 18 haven't been tested, though. No studies have looked at whether Harvoni is safe for use during pregnancy or breastfeeding, but animal studies didn't find any risks. However, pregnant or nursing women should take Harvoni only if the benefits outweigh any possible risks.

  Harvoni can interact with a wide variety of drugs, including antacids, cholesterol-lowering drugs, anti-seizure drugs, HIV medications, the heart rhythm drug digoxin and St. John's wort. These interactions can decrease the effectiveness of Harvoni or the other drugs, or increase the side effects caused by the other drugs. Before you take Harvoni, make sure your doctor is aware of all medications and supplements you are taking.

  In more than 90% of people who take Harvoni, the hepatitis C virus is no longer detectable after eight to 24 weeks. Doctors consider this a cure. However, it isn't known if Harvoni can prevent you from infecting another person while you are taking the drug. Talk with your doctor about ways to prevent spreading the virus to others.

• QWhat foods or medications can Harvoni interact with?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Harvoni (ledipasvir and sofosbuvir) can interact with many different types of medications. These include:

  • acid-blocking drugs used for heartburn (such as Pepcid, Tagamet and Zantac)
  • antacids containing aluminum or magnesium
  • the heart medication digoxin (Lanoxin)
  • anti-seizure drugs (such as Trileptal, Luminal and Dilantin)
  • the antibiotics rifampin, rifabutin and rifapentine
  • HIV medications
  • the hepatitis C drug simeprevir (Olysio)
  • the cholesterol drug rosuvastatin (Crestor)
  • the herbal supplement St. John's wort

  Harvoni should not be taken with the antiarrhythmic drug amiodarone, as it could cause heart rate to slow sharply. Some cases have led to fatal heart attacks or caused people to need pacemakers. Other drugs that affect heart rhythm can also cause a slow heart rate when used with Harvoni, leading to symptoms such as fainting, dizziness, fatigue and confusion. 

  Before starting Harvoni or any new medication, be sure your doctor is aware of all other prescriptions, over-the-counter drugs or supplements you are taking. 

• QWhat are the possible side effects of Viekira Pak?

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  A Diana Meeks , Family Medicine, answered on behalf of Sigma Nursing

  Like other newer hepatitis C drugs, Viekira Pak tends to have fewer and less severe side effects than older treatments did. However, in people with advanced liver disease, Viekira Pak can cause liver failure, sometimes leading to liver transplantation or even death.

  Otherwise, the most common side effects are nausea, itching and sleep problems. When Viekira Pak is used along with another hepatitis C medication, ribavirin, side effects may also include fatigue, weakness and skin redness or a rash. In clinical trials before Viekira Pak was approved, most side effects were mild. Only 1% of people stopped taking Viekira Pak because of side effects.

• QCan Viekira Pak interact with other medications or foods?

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  A Diana Meeks , Family Medicine, answered on behalf of Sigma Nursing

  Viekira Pak can interact with a number of drugs. Some interactions may make Viekira Pak or other drugs less effective, or increase the risk and severity of side effects. Most notably, women should stop using medications containing ethinyl estradiol, a form of estrogen, before starting Viekira Pak. These medications include certain birth control pills, vaginal rings or patches, and hormone replacement drugs. If you use one of these medications for birth control, you should use a different method until at least 2 weeks after you finish taking Viekira Pak. Using these medications with Viekira Pak can cause liver problems.

  Other medications that shouldn't be used with Viekira Pak include:

  • certain cholesterol-lowering drugs
  • certain anti-seizure medications
  • certain sedatives
  • certain HIV medications
  • certain migraine drugs
  • the herb St. John's wort

  This isn't a complete list. You should be sure to tell your doctor and pharmacist about all medications, prescription and non-prescription, that you take, as well as herbal supplements. Also, carefully read the handout given to you with your prescription for a more complete list. 

• QWhat should I know about Viekira Pak before taking it?

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  A Diana Meeks , Family Medicine, answered on behalf of Sigma Nursing

  Here are some key facts to know before you take Viekira Pak:

  • Viekira Pak isn't recommended for people with advanced liver disease, because it can lead to severe liver injury and/or failure.
  • Women should not use medications containing ethinyl estradiol, a type of estrogen, while taking Viekira Pak. This includes certain birth control pills, vaginal rings and patches, and hormone replacement drugs. They can interact with Viekira Pak and cause liver problems. Women should use a different form of birth control while taking Viekira Pak and for at least two weeks after stopping it. 
  • Viekira Pak may interact with many other drugs. Tell your doctor and pharmacist about all other medications, prescription or nonprescription, and supplements you take. 
  • Viekira Pak usually causes only mild side effects, including nausea, itching and sleep problems. Tell your health care provider right away if you begin to have any of these symptoms while taking Viekira Pak, or if they worsen: yellow skin or eyes, color changes in your stools, fatigue or weakness, loss of sppetite or upset stomach. 
  • Tell your doctor if you're pregnant or plan to become pregnant. Studies haven't yet determined if Viekira Pak is safe to take during pregnancy. However, Viekira Pak is often taken along with another hepatitis C drug, ribavirin, and ribavirin is known NOT to be safe in pregnancy. Ribavirin may cause birth defects or death of the baby if taken during pregnancy. The male partners of women who are pregnant should also not take ribavirin. 
  • It isn't known if breastfeeding is safe while taking Viekira Pak. Ask your doctor about the best way to feed your baby while taking Viekira Pak.