A Full List of Hepatitis C Medications

Direct-acting antivirals (DAAs) are the most common treatment for hepatitis C. They’re usually taken as pills. These medications can cure hepatitis C in 90–97% of cases. They work by helping to stop HCV from multiplying.

Three types of DAAs are used for hepatitis C. They work on nonstructural (NS) proteins or enzymes to stop HCV from multiplying. These types are:

• NS3/4 protease inhibitors, which target an enzyme
• NS5A inhibitors, which target a protein
• NS5B polymerase inhibitors, which target an enzyme

Different DAA medications are taken in combination with each other to provide effective treatment. Some treatments are available as pills containing two or more drugs.

Doctors may use two other medications in combination with DAAs: ribavirin and interferons.

Each medication type has different benefits, side effects, and risks.

Treatments to cure HCV are not approved for use during pregnancy, according to the Centers for Disease Control and Prevention. If you’re pregnant, you can start treatment after your baby is born or once you’ve finished nursing.

We’ll look at each medication type in more detail below.

DAAs are currently the standard of care for chronic HCV infection. These drugs work by attacking HCV directly.

This means they’re more targeted than older treatments such as interferons, which are covered below.

Also, DAAs do not affect as many systems in your body as interferons do, so they may not cause as many side effects. Usually, the side effects of DAAs are mild to moderate in severity.

DAAs can cure HCV in more than 90% of cases with 8–24 weeks of treatment.

Side effects of DAAs can include fatigue and headaches.

Less common side effects include:

• anemia
• diarrhea
• nausea
• vomiting
• slow heartbeat

All DAAs are oral drugs that you swallow. Follow a doctor’s or pharmacist’s instructions on how to take these medications. They can also tell you what side effects are possible and advise on any symptoms of serious side effects to look out for.

Protease inhibitor antiviral medications (NS3/4A inhibitors)

Protease inhibitors can help prevent the spread of infection within your body by stopping viruses from multiplying.

Grazoprevir is a protease inhibitor for hepatitis C genotypes 1 and 4. It’s available only in combination with elbasvir and is sold as elbasvir-grazoprevir.

This drug combination is sold under the brand name Zepatier.

NS5A inhibitors

The action of these drugs isn’t fully understood. They may work by stopping the virus from copying itself. They may also help prevent drug resistance (when a drug no longer works to treat a condition).

These drugs can treat all HCV genotypes. They’re used alone or in combination with other medications.

Examples of directed inhibitors include ledipasvir (a component of the combination drug Harvoni) and elbasvir (a component of the combination drug Zepatier).

Nucleotide/nucleoside and non-nucleoside polymerase inhibitors (NS5B inhibitors)

These drugs work by blocking an enzyme called NS5B. HCV needs this enzyme to replicate itself and survive.

Sofosbuvir (Sovaldi) is an example of an NS5B inhibitor.

All DAAs are given as combinations. Some combinations are available as single pills to make the medication easier to take. Brand names of current combination therapies include:

• Harvoni
• Zepatier
• Epclusa
• Vosevi
• Mavyret

Doctors use Harvoni, which contains ledipasvir and sofosbuvir, to treat HCV genotype 1. It was approved in 2014.

This medication is available as a tablet or as pellets. You should take this medication at the same time every day.

If you take the pellet form, you can sprinkle the packet of pellets on a small amount of room-temperature or cold food that is non-acidic, such as pudding or mashed potatoes. You must finish eating the combination within 30 minutes. Eat the pellets on soft food so you can avoid a bitter taste released by chewing them.

Zepatier contains elbasvir and grazoprevir. The FDA approved this drug in 2016 to treat HCV genotypes 1 and 4.

Zepatier is available as a tablet. You should take it at the same time every day.

Epclusa, which contains sofosbuvir and velpatasvir, was approved in 2016. It can be used in combination with ribavirin in people with moderate to severe cirrhosis. It’s available as a tablet or as pellets.

Epclusa was the first medication to treat all six HCV genotypes.

You should take this medication once every day. If you’re taking the pellet form, mix it with a small amount of non-acidic soft food, such as pudding or mashed potatoes. Swallow the mixture without chewing. You should finish eating the mixture within 15 minutes.

The FDA approved Vosevi in 2017 to treat any HCV genotype. It contains the drugs sofosbuvir, velpatasvir, and voxilaprevir.

Vosevi is intended for use when sofosbuvir has not been successful in treating hepatitis C.

This medication is typically taken once every day with food.

The FDA approved Mavyret in 2017 for use in the treatment of any HCV genotype. It contains glecaprevir and pibrentasvir.

Mavyret is the first treatment that can be administered for only 8 weeks in people without cirrhosis. Most of the other combination drugs must be administered for at least 12 weeks.

This medication is available in tablets and pellets. If your doctor prescribes tablets, you’ll typically take 3 pills at the same time every day. Mavyret tablets should be taken with food.

Mavyret pellets should be sprinkled onto a spoonful of soft, sticky, low-water food such as peanut butter, thick jam, or cream cheese. Swallow the mixture without chewing. Be sure to finish consuming the mixture within 15 minutes.

Ribavirin works by stopping viruses from replicating and spreading. It’s an oral medication that comes in several strengths. It is available in the following forms:

• capsule
• tablet
• liquid

Ribavirin on its own is not an effective treatment option for HCV. Doctors often use it in combination with other drugs to help them be more effective. They typically recommend ribavirin in situations with complicated disease progression or when other treatment regimens have not been successful. The most common brand name for ribavirin is Rebetol.

A doctor or pharmacist will give you instructions for taking ribavirin. You should take it with food. Typically, you’ll take it twice a day — once in the morning and once in the evening. It’s important to swallow the pills whole. If you’re taking liquid ribavirin, shake the bottle well before every use.

Ribavirin can cause fetal development irregularities

Ribavirin may cause fetal development issues if taken before or during pregnancy. It’s important to avoid pregnancy while you or your partner is taking ribavirin. And if you are pregnant, you should not have sexual intercourse with a person assigned male at birth who is taking ribavirin.

If you’re planning to become pregnant, it’s important to wait until after you’ve stopped taking ribavirin. People assigned female at birth must wait 9 months after stopping ribavirin before starting a pregnancy. People assigned male at birth must wait 6 months after stopping the drug before they attempt pregnancy with a partner.

Other side effects of ribavirin

Other side effects of ribavirin may include:

• decreased red blood cell counts and anemia
• nausea and vomiting
• changes in your sense of taste
• memory loss
• trouble concentrating
• difficulty sleeping
• muscle pain
• dermatitis
• alopecia

These days, interferons are not commonly used to treat HCV. The newer treatments listed above are typically used instead. This is because interferons can cause a lot of side effects and are not as effective for treating chronic HCV infection.

However, doctors may recommend using this medication alongside DAAs in cases of more complicated disease progression or when other treatment regimens do not work.

Interferon is a protein. It helps your immune system develop an immune response to viruses, including HCV. Peginterferon alfa-2a (Pegasys) is a common brand-name interferon.

Common side effects of interferons include:

• anxiety
• dry mouth
• excessive fatigue
• headache
• mood changes or depression
• weight loss
• worsening hepatitis symptoms

More serious side effects can happen over time. These may include:

• autoimmune diseases, which happen when your immune system mistakenly attacks healthy cells
• reduced red blood cell counts, which can lead to anemia
• reduced white blood cell counts, which can lead to infections
• high blood pressure, which can lead to a stroke or heart attack
• reduced thyroid function
• vision changes
• liver disease
• lung disease
• inflammation of your bowel or pancreas
• allergic reaction
• slowed growth in children

Peginterferon alfa-2a is an injectable medication. Typically, it’s injected once a week into your abdomen or thigh.

As newer, more effective drugs have become available, some older HCV drugs have been discontinued. These include:

• simeprevir (Olysio), for genotypes 1 and 4
• paritaprevir, for genotype 1
• ombitasvir-paritaprevir-ritonavir (Technivie)
• dasabuvir-ombitasvir-paritaprevir-ritonavir (Viekira Pak)
• ombitasvir (a component of the combination drug Viekira Pak)
• dasabuvir sodium (a component of the combination drug Viekira Pak)
• peginterferon alfa-2b (Sylatron)
• daclatasvir (Daklinza)

Paritaprevir was a drug available only as part of the combination drugs Viekira Pak and Technivie.

Some brand names of ribavirin have also been discontinued. These include:

• Ribasphere
• Ribasphere RibaPak
• Copegus
• Moderiba

What is the best medication for hep C?

The current standard of care for hepatitis C involves direct-acting antivirals because they directly attack the virus and have a tolerable side effect profile compared with older treatment options.

The most effective medication with the fewest side effects for hepatitis C may depend on other factors, such as the HCV genotype and your overall health. Doctors may also recommend combinations of medications.

What is the new drug to cure hep C?

The FDA approved glecaprevir-pibrentasvir (Mavyret) in 2017 for hepatitis C. Doctors can use it to treat any HCV genotype.

What medication is used to treat hepatitis?

Doctors may prescribe different medications to treat hepatitis C, depending on many factors, including your overall health and the HCV genotype you have. In some cases, doctors may recommend multiple medications.

What is the fastest cure for hep C?

Glecaprevir-pibrentasvir (Mavyret) can treat hepatitis C in 8 weeks in people without cirrhosis. You typically need to take other hepatitis C medications for 12 weeks.

Hepatitis C can cause unpleasant symptoms and lead to serious health complications.

Your treatment can depend on:

• your health
• the HCV genotype you have
• other factors

Different types of drugs used to treat hepatitis C work in different ways and can cause unique side effects.

For example, if you have serious kidney disease, you can use only certain HCV treatments. A doctor can talk with you about your options.

If you’ve ever had hepatitis B, talk with a doctor before starting HCV treatment. Treating HCV can sometimes cause a previous hepatitis B infection to come back.

Ask a doctor which medication might be a good fit for you. Together, you can find the most effective drug to treat your HCV infection with the fewest side effects.