Epclusa vs. Harvoni: What You Should Know

Epclusa and Harvoni each contain two active ingredients:

• Epclusa contains sofosbuvir and velpatasvir
• Harvoni contains ledipasvir and sofosbuvir

These active ingredients all belong to the same drug class, called antivirals. (A drug class is a group of medications that work in a similar way. An active ingredient is what makes a drug work.)

These active ingredient combinations are also available as generic versions. (A generic drug contains an exact copy of the active ingredient in a brand-name medication.)

Epclusa and Harvoni are used to treat hepatitis C in adults and children ages 3 years and older. This is a liver infection caused by the hepatitis C virus (HCV). There are six different genotypes (strains) of HCV.

• Epclusa can be used in people with any of the six genotypes of HCV, whether or not they have cirrhosis (liver scarring).

• Harvoni can be used in people with genotypes 1, 4, 5, and 6. For each of these genotypes, there are specific circumstances in which Harvoni can be used. It depends on whether the person has cirrhosis, as well as other factors.

Sometimes, your doctor might prescribe ribavirin with Epclusa or Harvoni.

For more details, see the prescribing information for Epclusa and Harvoni. Also, see the “Epclusa vs. Harvoni” section of this article.

Epclusa or Harvoni and children

Doctors can prescribe Epclusa and Harvoni to treat certain types of hepatitis C in children ages 3 years and older. As in adults (see above), Epclusa and Harvoni can be used in children with or without cirrhosis, and might be prescribed with ribavirin.

For more information about the use of Epclusa and Harvoni in children, talk with your child’s doctor.

Like all medications, Epclusa and Harvoni may cause side effects. The most common side effects are usually mild. They may be easy to manage or go away on their own. However, serious side effects are possible.

For more information about possible side effects, see these in-depth side effect articles on Epclusa and Harvoni.

Mild side effects

Epclusa and Harvoni may cause mild side effects. The chart below lists examples of mild side effects that can occur with these drugs.

This chart may not include all mild side effects of these drugs. For more information about mild side effects of each medication, see the prescribing information for Epclusa and Harvoni.

* This mild side effect occurred in studies of people taking ribavirin along with Epclusa.
† This mild side effect occurred in studies of people taking ribavirin along with Harvoni.

Serious side effects

The chart below lists possible serious side effects in people taking Epclusa or Harvoni.

If you have questions about your risk for serious side effects from either drug, talk with your doctor.

* Epclusa and Harvoni both have a boxed warning for this side effect. To learn more, see the “What are the warnings of Epclusa and Harvoni?” section below.
† This side effect has been reported by the manufacturer of Harvoni. In rare cases, it occurred in people taking sofosbuvir (one of the drugs in Harvoni) when used with ribavirin or pegylated interferon/ribavirin. Although suicidal thoughts or actions weren’t reported in studies of Epclusa, there may be a risk for this side effect because Epclusa also contains sofosbuvir.

Allergic reaction

Epclusa and Harvoni can cause an allergic reaction in some people. This side effect wasn’t reported in studies of Epclusa or Harvoni.

Symptoms of allergic reaction can be mild or serious. You can learn more about possible symptoms in this article.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Epclusa or Harvoni.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Epclusa or Harvoni, they may have you switch to a different treatment.

Whether you have health insurance or not, cost may be a factor when you’re considering these drugs. Keep in mind that what you’ll pay for either drug will depend on your treatment plan and health insurance, and the pharmacy you use.

Epclusa and Harvoni are both brand-name drugs. These drugs also have generic forms. You’ll usually pay more for brand-name drugs than for generics. If you’re interested in using the generic form of either drug, talk with your doctor.

For other resources that might help you save on the price of these drugs, you can refer to these cost articles about Epclusa and Harvoni.

Both Epclusa and Harvoni come as tablets and pellets that you take by mouth once per day.

The oral pellets can be easier to swallow. You may swallow these pellets on their own or mixed with nonacidic soft foods, such as mashed potatoes, pudding, or ice cream.

The table below shows the available strengths for each form of these drugs.

In children, Epclusa and Harvoni dosages are based on their body weight. Your child’s doctor will determine what dosage your child needs. And they might prescribe oral pellets for your child, especially if they’re under 6 years old.

For details about dosage, you can refer to this in-depth Epclusa dosage article and the “Dosage” section of this Harvoni article.

You may wonder if Epclusa or Harvoni would treat your condition effectively.

Studies have found both drugs to be highly effective at treating hepatitis C. And hepatitis C treatment guidelines recommend both drugs as first-choice treatment options.

It’s important to note that your results from Epclusa or Harvoni may differ from those seen in studies. Talk with your doctor about whether one of these drugs is right for you.

To learn about how each drug performed in studies, see the prescribing information for Epclusa and Harvoni. The manufacturer websites for Epclusa and Harvoni also provide information about each drug’s effectiveness.

Epclusa and Harvoni may not be right for you if you have certain medical conditions or other factors that affect your health. Before using either drug, talk with your doctor about your health history.

Boxed warning: Reactivation of hepatitis B virus

Epclusa and Harvoni both have a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

If you’ve had both hepatitis B and hepatitis C, using Epclusa or Harvoni could cause the hepatitis B virus (HBV) to reactivate. This means that the virus flares up and causes symptoms of hepatitis B infection again. Sometimes, HBV reactivation may lead to liver failure or death.

Your doctor will test you for hepatitis B before you start treatment with Epclusa or Harvoni. If you have the infection, you may need to take medication to treat it before you use either of these drugs.

Other warnings

In addition to the boxed warning, Epclusa and Harvoni have other warnings.

Before using Epclusa or Harvoni, talk with your doctor if any of the following conditions or health factors apply to you:

• if you’ve had an allergic reaction to either drug or any of its ingredients
• if you’re pregnant or breastfeeding
• if you take amiodarone, a heart medication
• if you take medications that interact with Epclusa or Harvoni
• if you have kidney problems or are on dialysis
• if you have HIV

To learn more about these drugs and their warnings, see the in-depth articles on Epclusa and Harvoni. You can also refer to these specific articles about interactions with Epclusa and Harvoni.

The short answer: It’s not likely.

Details: Epclusa and Harvoni are very similar medications. They even contain one of the same active ingredients (sofosbuvir).

Once you start using Epclusa or Harvoni, you’ll stick with the same drug for your entire treatment. Because the drugs are so similar, there wouldn’t be a reason to switch from one to the other.

For instance, it’s rare to have a severe allergic reaction to one of these drugs. If this occurs, switching to the other drug would not be beneficial because they share an active ingredient.

If you experience a severe allergic reaction or another serious side effect from either Epclusa or Harvoni, you and your doctor will discuss your treatment options. These likely won’t include switching to the other drug.

Reminder: You shouldn’t switch drugs or stop your current treatment unless your doctor recommends it.

If you have hepatitis C, Epclusa or Harvoni may be treatment options for you. To learn more about these treatment options, talk with your doctor. They can determine if one of these drugs may be right for you.

Here are some questions you may want to ask your doctor:

• How will I know if Epclusa or Harvoni reactivates my hepatitis B virus?
• Does having HIV raise my risk of side effects from either of these drugs?
• After I complete my treatment with Epclusa or Harvoni, am I at risk of getting hepatitis C again?
• Which HCV genotype do I have, and how long would I be able to take Harvoni?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.