Jisandai/Bingtonsha instruction manual download: Indications and contraindications

1. Indications:

The third generation of Gilead , the generic name is Sofosbuvir/Velpatasvir (Sofosbuvir/Velpatasvir), the trade name is Epclusa, and it is also often called "Epclusa" in China. It is a product of Gilead Sciences of the United States. The third-generation direct antiviral drug (DAA) developed by Hepatitis C (HCV) has brought a major breakthrough. Its biggest highlight is that it has "pan-genotypic" indications, that is, it has a therapeutic effect on all major HCV genotypes from types 1 to 6, without the need for complex genotyping testing before treatment.

According toEpclusa's global instructions and Chinese registration information, the drug is suitable for adult and pediatric patients aged 3 years and above. For patients with chronic hepatitis C virus infection, regardless of whether they have mild cirrhosis (compensated cirrhosis), this drug can be used for a 12-week standard course of treatment.

For patients with more severe disease who have developed decompensated cirrhosis, Epclusa is recommended to be used in combination with ribavirin to enhance the antiviral effect and reduce the risk of relapse. In addition, the drug also shows good efficacy and tolerability for special groups such as HCV and HIV co-infected people, previous treatment failures, and patients after liver transplantation.

2. Medication contraindications:

However, despiteEpclusa's broad range of indications, there are clear contraindications to its use. The primary contraindication is for individuals who cannot be combined with ribavirin, such as pregnant women or those preparing to become pregnant, and patients with certain hematological diseases. Such groups need to carefully assess the risks. In addition, Epclusa is prohibited from being used concurrently with strong CYP enzyme inducers (such as rifampicin, carbamazepine, St. John's wort, etc.). These drugs will significantly reduce blood concentrations, thus weakening the therapeutic efficacy of Epclusa. Similarly, strong inducers of P-glycoprotein are also contraindicated drugs, and combined use may lead to treatment failure.

3. Medication management:

Routine screening for HBV (hepatitis B virus) infection status should be performed before using this product, because DAA may induce the reactivation of latent HBV after clearing HCV, leading to severe liver function damage. Especially for HBsAg-positive or HBcAb-positive patients, special attention should be paid to viral monitoring and possible combination therapeutic intervention.

4. Mechanism of action

The core mechanism of action of Epclusa consists of two parts: sofosbuvir inhibits NS5B polymerase activity and directly blocks viral RNA replication, while velpatasvir targets the NS5A protein and interferes with the formation of the viral replication complex. This dual-target mechanism gives Epclusa the advantages of strong potency, high efficiency, and low drug resistance in the treatment of hepatitis C.

5. Adverse reactions

It is worth noting that Epclusa’s side effects are generally mild, with the most common ones being headache, fatigue, nausea and insomnia, which mostly resolve spontaneously as treatment continues. In order to ensure the stable effect of the medicine, it is recommended to take the medicine at a fixed time every day, with meals or on an empty stomach. It is not recommended to increase or decrease the dose or interrupt the treatment course on your own.

Judging from the current global guidelines,Epclusa has become the first-line recommended hepatitis C treatment drug. Especially under the promotion of the policy of "universal screening and early treatment", its universal applicability and high cure rate are of great significance to public health. Before starting treatment, patients should have their general condition, concomitant medications, and infection history evaluated by their physician to ensure the accuracy and safety of drug use.

Reference: https://www.epclusa.com/