Sofosbuvir

Sofosbuvir is a medication used to treat chronic hepatitis C virus (HCV) infection. It belongs to a class of antiretroviral drugs known as nucleotide analogue HCV NS5B polymerase inhibitors. It is taken in combination with other medications to treat HCV infection.

Uses

Sofosbuvir is used in combination with other medications to treat chronic hepatitis C virus (HCV) infection in adults and to prevent reinfection in people with HIV and HCV co-infection. It is sometimes used in combination with ribavirin to treat HCV infection in children. It is also used to treat decompensated cirrhosis in people with HCV genotype 1, 4, 5, or 6 infection.

Brand Name	Sofosbuvir
Type
Weight
Generic	Sofosbuvir
Manufacturer
Available in	English বাংলা

Mechanism of Action

Sofosbuvir works by inhibiting the HCV NS5B polymerase enzyme that is responsible for viral replication. This prevents the virus from replicating and leads to a decrease in viral load in the body. Sofosbuvir is also known to have activity against other viruses such as the human cytomegalovirus, the rhinovirus, and the Epstein-Barr virus.

How Long Does it Take to Work?

Sofosbuvir usually takes several weeks to months to start working. Typically, patients taking sofosbuvir in combination with other antiviral medications can expect their HCV virus to be eliminated within 12 to 24 weeks of treatment. In some cases, it may take longer than 24 weeks to achieve a sustained virological response (SVR), or the complete elimination of HCV.

Absorption

Sofosbuvir is rapidly and extensively absorbed when taken orally. It reaches peak concentrations in the blood 1-2 hours after ingestion. It is widely distributed in the body and reaches high concentrations in the liver, which is the target organ for HCV.

Route of Elimination

Sofosbuvir is metabolized in the liver and is eliminated primarily in the feces via biliary excretion. Very little is excreted unchanged in the urine.

Dosage and Administration

The recommended dosage of sofosbuvir depends on the patient’s HCV genotype and prior treatment experience. It is usually taken once daily for 8 to 24 weeks, depending on the patient’s HCV genotype and other medications included in the treatment regimen. Patients should take sofosbuvir with food to enhance absorption.

Side Effects

Common side effects of sofosbuvir include fatigue, headache, nausea, vomiting, and diarrhea. Other side effects that have been reported less frequently include rash, abdominal pain, anemia, insomnia, joint pain, and dizziness.

Toxicity

The most common adverse reactions associated with the use of sofosbuvir are nausea and fatigue. Serious adverse reactions that have been reported include liver failure and hypersensitivity reactions. Injection site reactions have also been reported.

Precautions

As with all medications, it is important to follow your healthcare provider's instructions when taking sofosbuvir. It is also important to tell your healthcare provider about any other medications you are taking, including vitamins, herbal supplements, and over-the-counter medications.

Interactions

Sofosbuvir may interact with other medications, including anticoagulants, selective serotonin reuptake inhibitors (SSRIs), certain antibiotics, anticonvulsants, and immunosuppressants.

Disease Interaction

Sofosbuvir should be used with caution in patients with certain diseases, such as HIV, liver cirrhosis, hepatitis B virus infection, and chronic kidney disease. It may also not be recommended for use in patients with heart failure due to the risk of dangerous arrhythmias.

Drug Interaction

Sofosbuvir should not be taken with certain medications, as it may interact with them and cause serious side effects. These medications include certain immunosuppressants, including cyclosporine; rifampin and its metabolites; certain antivirals, including boceprevir and telaprevir; and certain antibiotics, including telithromycin, fluoroquinolones, and isoniazid.

Food Interactions

Sofosbuvir should be taken with food to improve its absorption. High-fat meals may increase the bioavailability of sofosbuvir, while low-fat meals may decrease it. Grapefruit or grapefruit juice may also interact with sofosbuvir and should be avoided.

Pregnancy and Lactation Use

Sofosbuvir has not been studied in pregnant women. Therefore, it should be used in pregnant women only if the potential benefit justifies the potential risk to the mother and fetus. It is not known if sofosbuvir is excreted in breast milk, so it should be used with caution in breastfeeding women.

Acute Overdose

It is not known if an overdose of sofosbuvir can occur. If an overdose is suspected, seek medical attention immediatley. Symptoms of an overdose may include nausea, vomiting, abdominal pain, and fatigue.

Contraindication

Sofosbuvir should not be taken by people who have moderate or severe liver impairment or by people who are taking certain medications, such as St. John’s wort, efavirenz, rifampin, and boceprevir.

Directions for Use

Sofosbuvir should be taken as directed by your healthcare provider. It should be taken once daily with food to enhance absorption. The dosage should be individualized according to the patient’s HCV genotype and prior treatment experience. Take sofosbuvir exactly as prescribed and do not change your dose or treatment schedule without the advice of your healthcare provider.

Storage Conditions

Sofosbuvir should be stored at a temperature between 15 and 30°C (59 and 86°F). Keep this and all other medications out of the reach of children and pets.

Volume of Distribution

The volume of distribution of sofosbuvir is 400 L, indicating that it is widely distributed in the body.

Half-Life

The half-life of sofosbuvir is approximately 242 minutes (4 hours).

Clearance

The clearance of sofosbuvir is 79.3 L/hr, indicating that it is rapidly eliminated from the body.

Dosage Information

The recommended dosage of sofosbuvir is 400 mg (one tablet) taken once daily with food. Depending on the patient’s HCV genotype and prior treatment experience, it is usually taken for 8 to 24 weeks. It should always be taken in combination with other antiviral medications.

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