If you have hepatitis C, your doctor may prescribe an antiviral medication, such as Mavyret (glecaprevir and pibrentasvir) or Epclusa (velpatasvir and sofosbuvir). Hepatitis C is an infection caused by the hepatitis C virus (HCV).

Both Mavyret and Epclusa are used to cure the disease.

Mavyret and Epclusa have differences too. You should read to learn how these drugs compare.

Note: For more information about these drugs, see the in-depth articles on Mavyret and Epclusa.

The drugs Mavyret and Epclusa are in are called antivirals. Drugs are grouped together by how they work.

Both of them are combination medications.

  • The drugs glecaprevir and pibrentasvir are active.
  • The drugs velpatasvir and sofosbuvir are active.

Mavyret and Epclusa are both prescribed to treat chronic hepatitis C in adults and in some children. “Chronic” means long term. (For information on the use of these drugs in children, see the “Mavyret and children” and “Epclusa and children” sections below.)

For this use, hepatitis C must be caused by specific genotypes of the hepatitis C virus (HCV). Each hepatitis C genotype has its own genetic makeup.

Both Mavyret and Epclusa are used to treat the disease.

  • HCV genotypes 1 to 6 in adults who have mild cirrhosis (liver scarring) or no cirrhosis

Mavyret is used to treat the disease.

  • Adults with the condition that has been treated but not cured with a different medication.

ribavirin is used to treat the disease.

  • Adults with severe cirrhosis have a higher incidence of the HCV genotypes 1 to 6.

See this article for details about Mavyret’s use for hepatitis C. You can also see this article for details about Epclusa’s use for hepatitis C.

Mavyret and children

Children 3 years and older are able to use Mavyret. This drug is used to treat the disease caused by:

  • Children with the same condition who have been treated but not cured with a different medication have the same strain of the disease.

Epclusa and children

Children 3 years and older are able to use pheclusa. This drug is used to treat the disease caused by:

  • Children with mild or no cirrhosis have the same number of strains of the HCV.
  • Children with severe cirrhosis can have a number of the HCV genotypes 1 to 6.

“If you don’t have health insurance, cost may be a factor when you’re considering drugs. You should keep in mind that the price of the drug depends on your treatment plan, health insurance, and pharmacy.”

Mavyret and Epclusa are both brand-name drugs. Mavyret isn’t available in generic form. However, Epclusa tablets are available in generic form in one strength: 400 milligrams (mg) of sofosbuvir and 100 mg of velpatasvir. Generic drugs are exact copies of the brand-name product but usually cost less.

If you’d prefer to use a generic drug to treat hepatitis C, ask your doctor if the generic form of Epclusa, or a different generic hepatitis C treatment, is right for you.

Get answers to questions about Mavyret and Epclusa.

Do Mavyret or Epclusa interact with any other drugs?

Yes. Mavyret and Epclusa can interact with other drugs.

Both Mavyret and Epclusa interact with drugs.

  • digoxin (Lanoxin, Digitek) for heart failure
  • There are certain drugs that are used to treat HIV.
  • statins for lowering cholesterol, such as atorvastatin (Lipitor) or rosuvastatin (Crestor)
  • certain seizure drugs, such as phenytoin (Dilantin) and carbamazepine (Tegretol)

Mavyret interacts with drugs.

The drugs that Epclusa interacts with.

Mavyret and Epclusa may interact with certain herbs or supplements, too. For example, you shouldn’t take either medication with the herb St. John’s wort.

These aren’t all of the interactions possible with these drugs. For more information, see these in-depth articles on Mavyret and Epclusa. You can also talk with your doctor and pharmacist. In fact, you should talk with them before you use either drug. Telling them about any medications, vitamins, and herbs you use can help prevent interactions.

Can I take Mavyret or Epclusa if I have HIV and hepatitis C?

Yes, it’s possible. If you have both HIV and hepatitis C, you may be able to take Mavyret or Epclusa to treat your hepatitis C. Having HIV doesn’t change how either drug works in your body to help cure hepatitis C.

HIV treatment guidelines from the Department of Health and Human Services recommend that people with HIV as well as hepatitis C be treated for both conditions. Hepatitis C treatment can improve your liver and your overall health.

If you have HIV or hepatitis C, you should talk to your doctor about whether Mavyret or Epclusa is a good option.

What can happen if I miss a dose of Mavyret or Epclusa?

If you miss a dose of Mavyret or Epclusa, the level of drug in your blood may get too low. Mavyret or Epclusa may be less effective at treating the disease if the drug level is low.

The chance of your hepatitis C being cured is increased by missing doses of either drug.

Try to take both drugs at the same time. You should do this for the time prescribed by your doctor. Here are some tips to remember your medication.

  • Ask a friend, co-worker, or loved one to remind you.
  • Set a daily reminder on your computer or phone.
  • You can make a medication calendar and post it on your refrigerator.
  • Put the pill organizers on your bedstand or toothbrush.

If Mavyret or Epclusa cures my hepatitis C, can I have hepatitis C again?

It is possible to have a second case of the disease after you have been cured. This can happen if you have been exposed to the hepatitis C virus.

For your hepatitis C to be considered cured, you must have a sustained virologic response. This means tests can no longer detect HCV in your body. In rare cases, you could have a relapse if HCV is still present in your body. With a relapse, HCV becomes detectable and could start causing symptoms of hepatitis C again.

After your hepatitis C has been cured, there is a chance of contracting HCV again by being re-exposed to the virus. Taking certain precautions can help you avoid having hepatitis C again.

Could having certain health issues result in my doctor prescribing one drug over the other?

Yes. Your doctor may prescribe one drug over the other if he or she has a good knowledge of your health history. These may include:

  • Past hepatitis C treatments. They may choose one drug over the other based on any hepatitis C treatments you’ve tried before.
  • Liver function. If you have liver disease, Epclusa may be a better treatment choice for you.
  • Severe scarring of your liver. Mavyret isn’t used for treating hepatitis C if you have severe cirrhosis. However, Epclusa can be used with the drug ribavirin for this purpose.

Both Mavyret and Epclusa are tablets. You swallow the tablets or pellets whole. People who have trouble swallowing pills can be prescribed the pellets.

You should not chew or crush Mavyret tablets. Doing so may make Mavyret less effective. It is not known if breaking up the tablets is safe.

To treat hepatitis C with Mavyret, adults and children ages 12 years and older take three tablets together with food once each day. You’ll take Mavyret for 8, 12, or 16 weeks, depending on your condition and past treatments. The dosage for children ages 3 years to less than 12 years is below under “Mavyret dosage for children.”

“The dosage for Epclusa is dependent on your age. Adults take one pill with or without food every day for a year. The children’s dosage is described below.”

When Epclusa is prescribed with the drug ribavirin, the Epclusa dosage is typically the same as when the drug is taken alone.

Mavyret dosage for children

The dosage for treating hepatitis C in children is based on their weight. Children younger than 12 years old are prescribed pellets instead of tablets. After mixing with food, Mavyret pellets are taken once a day.

You should put Mavyret on food that will stick to a spoon. The pellets should be swallowed within 15 minutes.

Epclusa dosage for children

“The dose of Epclusa is dependent on the child’s weight. They take the dose their doctor prescribes once a day, with or without food, for a year. This is not different from whether they take it alone or with ribavirin.”

Children younger than 6 years are prescribed pills. The pellets should be sprinkled on non-acidic food. The pellets should be swallowed without chewing within 15 minutes.

Most people who have taken Mavyret or Epclusa have had no serious side effects. These are usually manageable and can be done in a day or two.

But in rare cases, people have had serious side effects with both drugs. Some serious side effects, such as hepatitis B reactivation, could happen after you’ve finished Mavyret or Epclusa treatment. Both drugs have a boxed warning about the risk of reactivation of hepatitis B virus. (See the “What are the warnings of Mavyret and Epclusa?” section below.)

Mild and serious side effects with these drugs are explained in this article.

For more information about the possible side effects of each drug, see the side effects articles for Mavyret and Epclusa.

Mild side effects

Some people may experience mild side effects from Mavyret and Epclusa. Mild side effects have been reported with these drugs.

Mavyret Epclusa
Headache X X
Fatigue (lack of energy)* X X
Nausea X X
High levels of bilirubin* (a byproduct of red blood cells being broken down), which may indicate liver problems X
Diarrhea X X†
Insomnia (trouble sleeping) X
Weakness X
Anemia (low red blood cell levels) X†

* This mild side effect may be a symptom of hepatitis C itself or of a serious side effect, such as reactivation of the hepatitis B virus (HBV). See the “What are the warnings of Mavyret and Epclusa?” section below for details.
† This mild side effect occurred in studies of people taking Epclusa with the drug ribavirin.

This chart may not include all mild side effects of these drugs. For more information on mild side effects of the two drugs, see Mavyret’s prescribing information and Epclusa’s prescribing information.

Serious side effects

There are some mild side effects that may occur in people using Mavyret or Epclusa. There are a number of possible side effects.

Mavyret Epclusa
Hepatitis B reactivation* (if you’ve had this virus before) X X
Serious allergic reaction X X

* Both Mavyret and Epclusa have a boxed warning for risk of hepatitis B reactivation. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “What are the warnings of Mavyret and Epclusa?” section below.

Discuss your medical history with your doctor about the risks of using these drugs.

You may wonder how effective Mavyret and Epclusa are at treating hepatitis C. In studies of Mavyret and Epclusa, both were highly effective at curing chronic hepatitis C caused by certain genotypes of the hepatitis C virus (HCV). Each hepatitis C genotype has its own genetic makeup.

According to the latest treatment guidelines from American Association for the Study of Liver Diseases, both drugs can be first-choice treatments for hepatitis C in people who:

  • “Have the same strain of the disease as the one that’s 1 to 6.”
  • don’t have cirrhosis (liver scarring), or have mild cirrhosis, and
  • Have you been treated for the disease?

If you’d like to read more about how each drug performed in studies, see the prescribing information for Mavyret and Epclusa.

If you have a medical condition that affects your health, Mavyret and Epclusa may not be right for you. These are referred to as warnings. The drugs have the same warnings, but they have different ones. Some of the warnings are mentioned.

If you are using Mavyret or Epclusa, you should talk with your doctor to make sure that the warnings apply to you.

Boxed warning: Hepatitis B reactivation

Mavyret and Epclusa 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.

Hepatitis B reactivation. If you’ve had hepatitis B in the past, using Mavyret or Epclusa could make the hepatitis B virus (HBV) reactivate in your body. This means HBV could flare up again. In rare cases, flare-ups can cause serious or fatal liver failure.

If you have had the disease, you should tell your doctor if you want to take either drug. If you have the disease, you may need to have treatment. Your doctor may watch you closely after treatment.

Other warnings

There are other warnings in addition to the boxed warnings.

If you have any of the conditions listed, talk to your doctor about using Mavyret or Epclusa.

  • Warnings for Mavyret:
    • if you take the HIV drugs Atazana is a drug. (Reyataz) or Evalurenz. (Sustiva)
  • Warnings for Epclusa:
    • If you take amiodarone, you will have arrhythmia.
    • if you can’t take the antiviral drug ribavirin, but would require combination treatment of Epclusa and ribavirin to treat hepatitis C in certain situations
  • Warnings for both Mavyret and Epclusa:
    • If you are pregnant or breastfeeding.
    • If you take the herb.
    • If you take the antibiotic rifampin.
    • If you have a transplant.
    • If you have HIV.

To learn more about these drugs, see the in-depth articles on Mavyret and Epclusa.

The short answer: Probably not.

Details: Mavyret and Epclusa treatment involve short-term regimens. They need to be taken every day to help cure hepatitis C. Although they work in similar ways and are used for similar types of hepatitis C, they aren’t exactly the same. For example, they aren’t necessarily used for the same length of time.

Unless you have a serious side effect with either drug, you need to stick to the prescribed regimen. Taking the same drug for the amount of time they recommend is what this means. It is possible that your hepatitis C will be cured if you do this.

Your doctor will test you for the HCT at the end of your treatment. If the test can still detect the disease, they will prescribe a new treatment.

If you have been cured of your hepatitis C, your doctor may prescribe Mavyret. This depends on a number of factors, such as your condition, type of hepatitis C, and past treatment.

“If Mavyret didn’t cure the condition, then it’s not a second treatment option. Other treatments are better.”

Reminder: To increase the chance of hepatitis C being cured, you need to take Mavyret or Epclusa exactly as prescribed. Don’t miss doses, switch drugs, or stop your current treatment unless your doctor recommends it.

Taking Mavyret or Epclusa may cure your hepatitis C. When taken exactly as prescribed, both drugs are highly effective at curing this disease.

If you have a condition that requires Mavyret for 8 weeks, you can take it for 12 weeks. If you have severe liver disease, your doctor may prescribe Epclusa.

Discuss the best choice with your doctor. They can answer your questions so that you are confident in your treatment. Ask about any concerns.

  • Do I have any health issues that make Mavyret or Epclusa a better fit?
  • What should I do if I miss a dose? Would I have to start over?
  • Is there any financial resources that would make one treatment cheaper?
  • If I am a good candidate for both drugs, are there reasons why one would be prescribed over the other?
  • Does one of these drugs have a higher rate of relapse?

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Q:

I take antiretroviral drugs to treat HIV. My doctor said both Mavyret and Epclusa interact with some HIV drugs. Which HIV medications interact with Mavyret and which ones interact with Epclusa?

Anonymous

A:

Mavyret and Epclusa can interact with HIV drugs.

Mavyret interacts with someone.

  • Evalurenz.
  • ritonavir is a word.
  • Atazana is a drug.
  • darunavir is a drug.
  • lopinavir is a drug.

The person interacts with the other person.

  • Evalurenz.
  • Tenofovir disoproxil is a drug.
  • tipranavir plusritonavir is a combination of two drugs. is a word.

Inform your doctor or pharmacy of all the drugs you take before taking either Mavyret or Epclusa. This includes all prescription and over-the-counter drugs. Your doctor or pharmacist can help determine which of your drugs may interact with each other.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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.