The hepatitis C virus, penetrating the human body, triggers an inflammatory process in the liver. The organ ceases to perform its functions correctly, its cells - hepatocytes - are gradually replaced by connective tissue, which leads to consequences such as fibrosis, or even cancer or cirrhosis. HCV has such a good ability to camouflage itself that it is detected mainly in a chronic state, and then by chance. However, as it turned out, there are no barriers for the “scientists” of our planet; an effective cure for hepatitis C has been developed!
The effectiveness of modern drugs against hepatitis C
Direct-acting antiviral drugs are highly effective in treating hepatitis. This method made it possible to abandon interferon therapy; sometimes you can do without Ribavirin. The duration of therapy depends on the severity of the disease and is prescribed individually to each patient; usually 12–48 weeks are enough for recovery. The sooner treatment begins, the less time it takes. The effectiveness of treatment decreases only with decompensated cirrhosis, but quite a lot of patients with this diagnosis recover.
These medications help even with the first genotype, which previously was practically resistant to treatment. Even HIV-infected people can get rid of hepatitis C using direct-acting remedies. The only drawback of this therapy is its cost, which often exceeds $100 thousand. Generic drugs, which have a composition similar to the original drugs, are more accessible to patients. When choosing such medicines, it is necessary to take into account that they comply with international standards and are produced under license in compliance with production technology. The cost of such drugs is several times lower. The list of generics is huge, so you need to be careful when choosing. The selection of an analogue should be carried out by the attending physician.
Therapy with Interferon and Ribavirin is not always effective. Patients with the first genotype of the virus are cured only in 50% of cases. Treatment according to this regimen should be long-term; side effects are often detected. Hepatoprotectors containing phospholipids are also used together with these medications.
Modern antiviral drugs can be combined with most medications; they cause virtually no side effects. However, you must notify your doctor about taking any medications or herbs.
Why do doctors recommend generics?
American medicines are certainly of high quality. However, they also have a significant drawback - prices are unaffordable for most patients from Russia. For a full course of DAAs from the USA, patients will have to pay at least 500 thousand rubles.
The situation was saved by the provision of an international license to 11 Indian pharmaceutical giants:
- Zydus Cadila Healthcare Ltd
- Natco Pharma Ltd
- Hetero Labs Ltd
- Mylan Laboratories Ltd
- SeQuent Scientific Ltd
- Strides Shasun Ltd
- Sun Pharmaceuticals Industries Ltd
- Biocon Limited
- Aurobindo Pharma Ltd
- Laurus Labs Pvt. Ltd
- Biocon Limited
- Cipla Ltd
Of these, high-quality generics produced by Zydus Heptiza, Natco Pharma, Hetero Labs and Mylan have received special recognition in the Russian Federation . Below is a list of the main products of these companies:
| Analogue from the USA | Zydus Heptiza | Natco Pharma | Hetero Labs | Mylan |
| Epclusa | SoviHep V | Velpanat | Velasof | MyHep All |
| Daclinza | Dacihep | DaclaHep | Natdac | MyDacla |
| Harvoni | LadyHep | Hepcinat LP | LediFos | MyHep LVIR |
Russian hepatologists recommend the following analogues of Sovaldi:
- SoviHep by Zydus Heptiza
- Hepcinat from Natco Pharma
- Sofovir from Hetero Labs
- MyHep by Mylan
Experienced specialists recommend therapy using Indian generics, since, despite the low prices, the quality of these drugs corresponds to American ones. This was made possible thanks to the use of the official formulation from Gilead.
In turn, the reduced cost of generics is a consequence of the fact that Indian pharmaceutical giants do not have to cover the costs of the American corporation for the long-term development of Sofosbuvir and other medicines. India only pays for the annual renewal of the license agreement.
Popular new generation drugs
Modern drugs used to treat hepatitis C are:
Sofosbuvir
- Sofosbuvir;
- Daclatasvir;
- Ledipasvir.
Sofosbuvir prevents the replication of the hepatitis C virus and is suitable for the treatment of all known genotypes. The duration of therapy depends on the time elapsed since infection, as well as existing complications. The main side effects are fatigue and headache. In some cases, fainting, insomnia, irritability, memory impairment, and dry mouth are possible. When combined with Interferon, the likelihood of such reactions increases.
Daclatasvir also suppresses the replication of the virus, but it is not advisable to use it for HIV-infected people. Side effects are similar to Sofosbuvir, but digestive disorders, bloating, hypertension, and skin rashes are also observed.
Ledipasvir prevents the virus from spreading in the body. It contains Sofosbuvir. The drug should not be used by patients with impaired renal and liver function. The drug is prescribed to patients with genotypes 1 and 4.
Considering the high price of these drugs, analogs with a similar composition and effect can be used. Such medications include: Gepsvir, Sovihep, Sofovir, Cimivir, Resof. It is recommended to give preference to generics of Indian origin. Egyptian drugs have also proven themselves well. They are cheaper than Indian ones, but they are difficult to get, since production is focused on the domestic market.
Resof
How much and how can you save on buying Indian generics?
Of course, price increases are an unpleasant fact. But you have to come to terms with it. As Gilead Sciences clients note: “Every year they increase our prices on everything, explaining this for some economic reasons, and we take it for granted.” In order not to overpay, be sure to check the cost before ordering and compare it with that recommended by the manufacturer. If the price is 10%-20% higher, most likely you are dealing with an intermediary who receives a percentage of sales or a person who profits from someone else’s problem. You can’t save on your health, but you shouldn’t overpay for medications, which can be purchased without increasing the cost by contacting licensed online resources or official dealers of the pharmaceutical company.
This article provides the patient with the following options:
- Avoid overpriced purchases from doctors and resellers.
- Avoid buying counterfeit drugs at a low price by determining the originality of the drug and ordering them from the list of approved sites and companies, which we will publish in the next article after research.
- The main thing is to be able to check the originality of the drugs 100%. For questions about the quality of drugs and their real cost, contact the Main Health Group of Companies.
Methods of application
Sofosbuvir is prescribed to all patients, but must be used in combination with other drugs. It is usually combined with Ledipasvir and Daclatasvir. The first drug already contains Sofosbuvir, so there is no need to take it separately. If the patient has been diagnosed with decompensated cirrhosis or immunodeficiencies, the Sofosbuvir-Daclatasvir regimen is used, supplemented with Ribavirin. The same treatment is required for patients who have previously taken interferons.
For the second and third genotypes, Ledipasvir is not recommended, but this medication has advantages for the treatment of HIV-infected people, since it interacts less with antiretroviral drugs than others.
Any of the described drugs is used according to the doctor’s recommendation.
The tablet should not be chewed or split into pieces as it is bitter. If vomiting occurs within two hours after administration, the drug must be taken again. If more time has passed since the use of the medication, re-dosing is not required. https://youtu.be/fg0PxGSTKTg
It is recommended to drink the medicine at the same time to enhance the therapeutic effect. If for some reason the patient misses taking a pill, you need to take it as soon as possible, but the break should not last longer than 20 hours. It is not recommended to take a double dose; it is better to skip it.
With an overdose of antiviral medications, the likelihood of side effects increases. An antidote has not been developed for them; only symptomatic therapy will help. In case of severe intoxication, the patient may be prescribed hemodialysis.
Any adverse events after taking new generation drugs should be reported to your doctor. If side effects occur, it is not recommended to stop therapy with antiviral drugs. Only a doctor can make such a decision if the patient’s condition has worsened.
Harvoni remedy
Doctors have a good opinion about this Indian medicine, primarily because it rarely causes side effects. Tests in patients using the drug "Harvoni" improve by the end of the second week. This medicine is usually prescribed one tablet per day with meals. Do not use a double dose if you accidentally miss taking this medication.
Doctors prescribe Harvoni to patients both with and without existing cirrhosis of the liver. Doctors speak well of this medicine also because it often has a positive effect even in cases where other drugs are ineffective. The only side effects that may occur during treatment with this drug are general fatigue and headaches.
This medicine will cost approximately 15 thousand rubles if ordered from India. for 28 tablets. For comparison: you can prescribe this medication from the USA for no less than 20-25 thousand rubles.
Restrictions on use
Ribavirin
Direct-acting antiviral drugs are not prescribed to patients under 18 years of age. They are also undesirable for pregnant and lactating women, since they have not been studied on them. Clinical studies have not been conducted on the effect of these medications on fetal development, so it is recommended to use at least two contraceptives during treatment. If Ribavirin is included in the treatment regimen, pregnancy should be avoided, even if only the partner has hepatitis C, since the medicine causes defects in the fetus. Contraception is used for six months after the end of treatment.
It is necessary to monitor the condition of patients taking new drugs for the treatment of hepatitis C if they have severe liver damage. Elderly people are prescribed such medications with caution.
Therapy with antiviral drugs is contraindicated in the following categories of patients:
- cancer patients;
- patients with mental disorders;
- people with a valve in the heart.
Patients with mental disorders treated with newer antiviral drugs experience severe depression and suicidal tendencies.
Interferon
In combination with Ribavirin, the newest antiviral drugs are prescribed in extreme cases, since adverse reactions will be more pronounced. Patients to whom this treatment method is applied complain of insomnia, headache, cough, and breathing problems. Their blood composition changes greatly: bilirubin increases and hemoglobin decreases. This treatment method requires constant monitoring of the patient’s condition. When Interferon is also included in this regimen, the situation is aggravated by a decrease in the number of leukocytes and platelets. The patient develops nervous disorders, concentration is impaired, and vision deteriorates. The combination of Sofosbuvir with Ribavirin and Interferon leads to significant weight loss and dehydration, which is sometimes accompanied by seizures.
During therapy with antiviral medications, allergic reactions to the components of the drug are often observed, which requires its discontinuation. Contraindication is lactose intolerance.
To reduce the likelihood of side effects, doctors recommend following a diet during treatment with antiviral drugs. It is necessary to exclude fatty and fried foods, flour products and alcohol.
Treatment of hepatitis C with new generation drugs is postponed if the patient is taking antiepileptic drugs, dexamethasone and antibacterial drugs. They are prohibited from being combined with Rifampicin, Rifapentine, Rifabutin. Patients should notify their doctor if they use products that contain St. John's wort. These drugs reduce the effectiveness of Sofosbuvir and Daclatasvir.
Daclatasvir
The newest antiviral drugs are not prescribed together with hepatoprotectors. Sorbents are allowed to be drunk 5–7 hours before taking Sofosbuvir. Sedatives are not used simultaneously with these drugs, since their concentration increases to a critical level.
Modern medications against hepatitis C are not combined with Amiodarone, since the patient may experience bradycardia. Cases of fatal cardiac arrest have been reported. When taking other antiarrhythmic drugs simultaneously, monitoring the patient's condition is required, for which he is prescribed control tests and monitored the activity of the heart. The patient must monitor his heart rate. Amiodarone remains in the body for a long time, so even after stopping its use, the patient needs to monitor his heart function.
Calcium channel blockers can be safely used with Sofosbuvir, but dose adjustment may be required when taking Daclatasvir and Ledipasvir.
Omez
Omez, used for excessive production of hydrochloric acid, reduces the effectiveness of Sofosbuvir. If it is necessary to take them simultaneously, an interval of 6 hours must be observed, however, there will be no need for Omez if the patient drinks a sufficient amount of liquid.
The antiretroviral drugs Atazanavir and Ritonavir increase the concentration of Daclatasvir, therefore, if such therapy is necessary, the dosage of the latter is reduced. During clinical studies, it was found that Tenofovir does not reduce the concentration of Daclatasvir, and their simultaneous use does not affect the dosage of the drug.
According to the guidelines, the drugs have not been studied in patients who have undergone liver transplantation or heart surgery. For them, such therapy may be dangerous.
During treatment with such drugs, you should avoid exposure to the sun. It is prohibited to visit the bathhouse and sauna. Sofosbuvir can increase blood pressure, so it should not be taken with caffeinated drinks.
Reaction speed and concentration when treating hepatitis C with the latest drugs deteriorates, so it is not recommended to drive vehicles or work with precision machinery at this time.
