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Sofosbuvir: Uses, Side Effects, Cost, and More

Test tube with blood sample for hepatitis C virus (HCV) test

Sofosbuvir is an oral antiviral that is FDA-approved to treat certain forms of chronic hepatitis C in adults and children 3 years and older. In this article, we will discuss its uses, mechanism of action, success rate, side effects, cost, and more.

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Sofosbuvir Quick Facts

  • Sofosbuvir belongs to a medication class called nucleotide polymerase inhibitors. 
  • The brand name of this medication is Sovaldi. No other brands of this medication are currently available. 
  • Gilead Sciences, Inc. received FDA approval in 2013 for Sovaldi. 
  • This medication should always be used with other antiviral medications to treat chronic hepatitis C. 

What Is Sofosbuvir?

Sofosbuvir is an antiviral agent. It is used with other antiviral medications to treat certain forms of chronic (long-lasting) hepatitis C. 

Hepatitis C is a viral infection of your liver. It causes liver inflammation and can lead to potentially life-threatening liver damage. The virus that causes this liver disease is known as the hepatitis C virus (HCV). 

According to the Centers for Disease Control (CDC), hepatitis C infection affects about 2.7 million people in the U.S. [1]

What Is Sofosbuvir Used For?

The FDA approved Sofosbuvir with other medicines (ribavirin and peginterferon alfa) to treat certain forms of chronic hepatitis C in adults. 

A healthcare provider may use this medication with ribavirin to treat certain types of chronic hepatitis in adults and children at least 3 years old. 

What Is the Mechanism of Action of Sofosbuvir?

Sofosbuvir blocks the activity of an enzyme that the hepatitis C virus needs to multiply. That way, it reduces the viral load (the amount of hepatitis C virus) in the body. 

What Is the Success Rate of Sofosbuvir?

According to recent data, using sofosbuvir with ribavirin can cure HCV in 90% of patients. Researchers think a similar success rate is achievable with a combination of sofosbuvir and other antivirals like daclatasvir, ledipasvir, or simeprevir [2].

How To Use Sofosbuvir Properly

This medication is available as an oral tablet and pellet in the following strengths:

  • Oral Tablets: 400 mg and 200 mg 
  • Oral Pellets: 200 mg and 150 mg 

Take the dosage exactly as prescribed and at the same time each day. Don’t take less, more, or take the medication for longer than prescribed. 

Never stop taking this medication without talking to your healthcare provider first. Follow the instructions on the prescription label. If you’re not sure how to take the medication, seek help from your prescriber or pharmacist.

You can swallow the tablets or oral pellets, with or without food. Avoid chewing your dose. 

You may also prepare a dose of the pellets with food. Sprinkle the pellets on one spoonful of pudding, chocolate syrup, mashed potato, or ice cream. Make sure the food, which should be non-acidic and soft, is at or below room temperature. 

Swallow all the mixture within 30 minutes. Avoid storing leftover mixture for future use. Instead, dispose of any unused mixture. 

Things To Know Before Taking This Medication

Inform your healthcare provider if you have:

  • Ever had a hepatitis B virus infection
  • Liver problems other than hepatitis C infection
  • Had a liver transplant
  • Serious kidney issues
  • Been on dialysis
  • HIV infection

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Use in Pregnancy and Lactation

Before starting treatment, inform your prescriber if you are pregnant or plan to become pregnant. It is yet to be determined if this medication will harm the unborn baby.

Before starting treatment, inform your prescriber if you are breastfeeding or plan to breastfeed. It has yet to be determined if this medication passes into breast milk.

Sofosbuvir Dosages

Adult dose for chronic hepatitis C infection

400 mg per day with other antiviral(s) for 12 weeks to 24 weeks, depending on the type of hepatitis C infection. 

Dose for chronic hepatitis C infection in children

For children at least 3 years old, your healthcare provider will determine the dose of sofosbuvir tablets or oral pellets based on your child’s body weight.

Who Shouldn’t Get This Medication?

Because sofosbuvir is always used with other antiviral drugs, contraindications to those drugs also apply to the combination treatment. 

Sofosbuvir Side Effects

Common side effects

Woman on bed suffering from fatigue from taking sofosbuvir

When used with both pegylated interferon and ribavirin, common side effects can include:

  • Fatigue
  • Headache
  • Nausea
  • Trouble sleeping
  • Anemia (low blood cell count)

When used with ribavirin, common side effects can include:

  • Fatigue 
  • Headache

Talk to your provider if these effects don’t go away or worsen. 

Serious side effects

Hepatitis B virus reactivation

Taking this medication can reactivate the hepatitis B virus if you have ever had hepatitis B infection. Reactivated hepatitis B virus can lead to liver failure and death. Reactivation may happen during or after treatment with sofosbuvir. 

Thus, you will need to go through blood tests to check for hepatitis B virus before initiating therapy. Also, your healthcare provider will monitor you for reactivation during and after treatment with sofosbuvir.

Consult your healthcare provider immediately if you have:

  • Excessive tiredness
  • Yellowing of the skin or eyes
  • Loss of appetite
  • Nausea and vomiting
  • Pale stools
  • Upper right stomach pain
  • Dark urine

Bradycardia (slow heart rate)

In patients using a heart medicine called amiodarone, sofosbuvir may cause a decrease in heart rate. Before starting sofosbuvir, inform your healthcare provider if you are taking amiodarone.

If you’re taking amiodarone and sofosbuvir, contact your healthcare provider immediately if you have: 

  • Dizziness or fainting
  • Fatigue
  • Shortness of breath
  • Chest pain
  • Confusion
  • Memory problems
  • Malaise

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What To Do If You Miss a Dose

Take the missed dose immediately after you remember it. Take the next dose at the regular schedule and stick to the recommended schedule. Don’t double dose.

What To Do If You Overdose

Seek emergency medical care or call the poison control helpline at 1-800-222-1222.

How Should You Store This Medication?

  • Store oral tablets and pellets below 86°F in the original container. 
  • Keep all your medications out of reach of children.
  • Keep all your prescription and OTC medications away from excess heat, light, and moisture.

How Much Does Sofosbuvir Cost?

The amount you pay for your treatment can vary, depending on your insurance plan, geographical location, and pharmacy. Call your insurance provider to learn if your plan covers this medicine or if you need prior authorization.

According to an economic analysis, a 12-week course of treatment with sofosbuvir costs $84,000 [3]. Because sofosbuvir is never used alone, the cost of combination treatment will be higher. 
You can contact us if you are interested in exploring financial assistance options for sofosbuvir.

REFERENCES:

  1. Rivera, W. (2023, August 18). Hepatitis C (HCV) – Symptoms, Causes & Treatments. American Liver Foundation. https://liverfoundation.org/liver-diseases/viral-hepatitis/hepatitis-c/ 
  2. Sofosbuvir as backbone of interferon free treatments Bourlière, Marc et al. Digestive and Liver Disease, Volume 46, S212 – S220
  3. Iyengar, Swathi et al. “Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis.” PLoS medicine vol. 13,5 e1002032. 31 May. 2016, doi:10.1371/journal.pmed.1002032
This information is not a substitute for medical advice or treatment. Talk to your doctor or healthcare provider about your medical condition prior to starting any new treatment. AmeriPharma™ Specialty Care assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result, nor is it responsible for the reliability of the content. AmeriPharma™ Specialty Care does not operate all the websites/organizations listed here, nor is it responsible for the availability or reliability of their content. These listings do not imply or constitute an endorsement, sponsorship, or recommendation by AmeriPharma™ Specialty Care. This webpage may contain references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with AmeriPharma™ Specialty Care.
MEDICALLY REVIEWED BY Dr. Samantha Kaeberlein, PharmD

Dr. Samantha Kaeberlein, PharmD was born and raised in Canton, OH. She received her pharmacy degree from Northeast Ohio Medical University (NEOMED) in 2020. The most rewarding part of her job is providing medical guidance so patients can make informed, well-rounded decisions regarding their healthcare. Her areas of expertise are geriatrics and long-term care. In her free time, she enjoys spending time outdoors, reading, and hunting for the best cup of coffee in America.

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