The liver is a kind of cleansing filter for the human body. The state of this organ affects the functioning of many systems and the quality of human life in general. Hepatitis C is considered one of the most severe liver lesions. Currently, many drugs have been developed to combat this disease. One of the most effective means is considered (which is confirmed by medical reviews) "Sofosbuvir".
Indications for use
In general, the active ingredient in tablets is called sofosbuvir, and the brand itself has the trade name Sovaldi. Thus, we can say that this medication is a cheaper substitute - generic Sofosbuvir, reviews of which describe the drug as one of the most effective drugs for the treatment of viral hepatitis C. This is its main area of application.
Where to buy Sofosbuvir andDaclatasvir without intermediaries?
The most useful information about where you can safely get your "course to recovery" is on thematic sites. The largest and most socially useful resource is HCV. RU, a Russian-language hepatitis forum called "at the bus stop", which was founded in 2001. As a rule, on forums with a reputation, all information is carefully checked by the administration and has a public assessment. If you do not take into account the Internet communities, then one of the most interesting offers that we managed to find on the Web is called the HepAssist Pro © program. More information about HepAssist © services can be found on the official website of the program.
The main substance - sofosbuvir - is an inhibitor of the NS5B viral polymerase, that is, it inhibits the process of reproduction of the virus - the causative agent of hepatitis C. However, most medical specialists do not recommend Sofosbuvir monotherapy (although this, in principle, is possible). But as the main active component of complex antiviral therapy, the drug "Sofosbuvir" reviews has only a positive orientation, characterizing it as a highly effective remedy. According to clinical studies, the drug in tandem with other medicines showed excellent results in the treatment of hepatitis C virus (genotypes 1, 2, 3).
Treatment with "Sofosbuvir" reviews of he alth workers characterize positively not only in relation to patients who have never been treated by him, but also in relation to those who have previously received antiviral therapy with other drugsmeans and at the end of treatment after a while who received a relapse.
In addition to the above-described area of impact, "Sofosbuvir" reviews of doctors and recommendations of the instructions can be used in the treatment of patients suffering from cirrhosis of the liver.
With regard to the effectiveness of the drug against co-infection of HIV and hepatitis (a fairly common situation), such information is not currently available, although the drug is indicated for use in such situations.
Contraindications
In the vast majority of cases, the drug itself and its generics were well tolerated by patients.
However, the drug for the treatment of hepatitis C "Sovaldi" (or "Sofosbuvir"), reviews of which are positive, like any modern highly effective drug, has certain contraindications for use.
Firstly, it is an individual hypersensitivity to the main and auxiliary components of the drug. Women of childbearing age should be careful when using it. In particular, if Sovaldi (Sofosbuvir) is prescribed in combination with Ribavirin and Interferon alfa (relevant for hepatitis genotypes 3, 4, 5, 6), pregnancy should be avoided in every possible way. It is also very undesirable to carry out treatment with these drugs during pregnancy and lactation.
Currently, there is no information on the effect of Sofosbuvir on human reproductive function. There is also no information aboutsafety and efficacy of the drug in patients under 18 years of age.
Methods of application and duration of therapy
First, it is worth mentioning that antiviral therapy should only be carried out by medical professionals who have sufficient experience in treating patients with hepatitis C. The standard regimen is 1 tablet (400 mg of active substance) during the day during any period of admission food. Since the tablets are bitter (these are the reviews from those who took the medication), Sofosbuvir should be swallowed without chewing or breaking.
If a pill has been taken and vomiting has started within the next 2 hours, it is recommended to take 1 more pill. If vomiting develops after a period of more than 2 hours, no additional dose is needed.
If the next dose of the drug for some reason was missed (the delay period is not more than 18 hours), it is recommended to take the missed dose, and then continue treatment at the usual time. If the delay exceeds 18 hours, take the next dose at the usual time.
Methods of combination therapy
As components of complex therapy in the treatment of hepatitis C, along with Sofosbuvir, the prescription of Ribavirin, Interferon alfa, Daclatasvir, Ledipasvir, Asunaprevir is practiced.
In general, the Sofosbuvir + Daclatasvir tandem is described by he alth workers and patients as effective in combating hepatitis C genotypes 1, 2, 3.
Genotypes 4, 5, 6 are treated with the complexdrugs "Sofosbuvir", "Ribavirin" and "Interferon alfa". The standard therapeutic period is at least 12 weeks. In cases where patients with genotypes 1, 4, 5, 6 have contraindications for taking Interferon alfa or hypersensitivity to this substance is established, Sofosbuvir with Ribavirin is prescribed for 24 weeks.
Tandem "Ribavirin" with the drug "Sofosbuvir" for genotype 2, reviews of experts are also characterized as an optimally effective combination, which is prescribed for admission for a period of at least 12 weeks. The same two medicines, but for a period of at least 24 weeks, are used for genotype 3 of viral hepatitis C.
Information on the effectiveness of complex therapy with "Ribavirin" and "Interferon" for the treatment of genotype 1 is not available.
In the event that the patient suffers from hepatocarcinoma and / or is awaiting liver transplantation, Sofosbuvir is prescribed in combination with Ribavirin for 48 weeks or until the moment of surgical intervention for organ transplantation. This is important to prevent infection of the liver after transplantation.
Conducted clinical studies suggest that the combined use of "Sofosbuvir" with other drugs allows you to get a consistently positive virological response in 92% of cases of complex therapy in the treatment of viral hepatitis C.
Possible side effects
In progress of clinic altrials, the drug was very well tolerated by patients (such were their reviews). Sofosbuvir causes side effects in most cases when used in combination with Ribavirin and Interferon.
When Sofosbuvir is combined with Ribavirin, quite often (in more than 10% of cases), the concentration of hemoglobin in the blood decreases and the level of bilirubin rises, fatigue, irritability and insomnia, nausea may occur.
Less often (in less than 10% of cases), this combination of medications provokes depression, anemia, nasopharyngitis, impaired concentration, dyspepsia, constipation and intestinal disorders, allergic manifestations on the skin (itching, rashes). Sometimes patients also leave such reviews: Sofosbuvir, used in parallel with Ribavirin, caused hair loss and back pain, convulsions, myalgia and asthenia.
If a complex of three medicines is used (Interferon alfa is added to the two above), very often (more than 10% of cases) a much wider list of side effects is observed. Here they talk about changes in the composition of the blood: this is a decrease in the number of lymphocytes, platelets and neutrophils, anemia, an increase in the level of bilirubin. On the part of the gastrointestinal tract, diarrhea, nausea, and vomiting may develop. In addition, Sofosbuvir (instruction, reviews of patients and he alth workers confirm) can cause headaches and dizziness, cough, shortness of breath, skin itching and rashes, myalgia and joint pain. Patients often talk about fatigue,irritability, chills, fever.
Less often (from 1 to 10%), patients talk about fears and the development of depression, weight loss, memory and concentration deviations, and migraines. There is information about the deterioration of vision, hair loss, the development of reflux and shortness of breath with increasing load. Sometimes patients talk about pain in the back and chest, cramps and asthenia.
What you need to know?
If a patient has one or more negative factors - an initially high viral load, progressive fibrosis, too dark skin - then treatment with Sofosbuvir (specialist reviews and instructions for use confirm) can be increased for a period up to 24 weeks. When conducting combination therapy, an effective dose of "Ribavirin" is selected in accordance with the patient's body weight, i.e. 75 kg of body weight require 1.2 g of medication. The entire volume of the drug is divided into two parts and taken with meals.
Reducing the dosage of Sofosbuvir is not recommended.
If the combined use of "Solfosbuvir" and "Interferon alfa" develops negative manifestations characteristic of the latter drug, the dose of "Interferon" taken should be reduced or completely discontinued taking this medication (detailed rules for reducing the dose or canceling the drug are available in special instructions).
They do exactly the same when a combination of Sofosbuvir and Ribavirin is used, and negative effects on the latter develop - the dose is reduced or completely stoppedtaking ribavirin. After the results of blood tests improve, it is permissible to try to resume taking Ribavirin, starting at 600 mg and gradually increasing to 800 mg. It is not recommended to increase the dose to the originally prescribed.
When canceling one of the complex therapy medications, you must completely stop taking Sofosbuvir - the reviews of specialists and instructions for use in this matter are the same.
Interaction with other substances
He alth workers do not recommend that patients use other antiviral drugs (other than those prescribed by the attending physician) in parallel with the drug in question during the period when hepatitis is being treated. "Sofosbuvir" reviews of experts consider it possible to combine with something else only in cases where the expected benefit from the combination of medicines outweighs the possible risk of developing undesirable effects.
There are also groups of drugs, the combined use of which with "Sofosbuvir" can significantly reduce its absorption ("Sofosbuvir") in the intestine. Such medicines - from anticonvulsants - include "Phenytoin", "Phenobarbital", "Carbamazepine" and "Oxcarbazepine". The antimycobacterial group of medicines also contains the following drugs: "Rifabutin", "Rifampicin", "Rifapentin". Of the herbal supplements, St. John's wort can significantly reduce the absorption of Sofosbuvir. It is also not recommended to combine the medication with HIV protease inhibitors: Tipranavir, Ritonavir.
Special Instructions
Only the attending physician has the right to choosetreatment regimens for hepatitis C and medications that will be prescribed for treatment: Ledipasvir, Asunaprevir, Sofosbuvir, Daclatasvir. Feedback from patients about all Sovaldi generics is positive.
However, it should be borne in mind that for patients with severe forms of renal failure, the dose volume must be selected specifically. There is no need to recalculate the dosage for those who suffer from mild and moderate pathology. With regard to liver failure, there is no need for dose adjustment for patients with any severity of the disease.
In the treatment of hepatitis C with the use of combination therapy based on Sofosbuvir, it is not recommended to engage in activities that require high concentration of attention and speed of psychomotor reactions.
Price range
The cost of a branded drug in Germany ranges from 18 to 20 thousand euros. Moreover, to purchase it, even at this price, you will need a prescription from your doctor. Such a high cost is due to the fact that the development company must recoup all its costs for research, development and testing of the drug.
Generic medicines (cheaper brand analogues with absolutely identical active ingredient) will cost the consumer much cheaper. These include Daclatasvir, Asunaprevir, Ledipasvir and Sofosbuvir. Consumer reviews contain information about the high cost of these medicines, but we are not talking about tens of thousands of euros.
Starting from March 2015, according to the license of the developer company, the production of Sofosbuvir began by the Indian pharmaceutical company Natko (of course, with the permission of the Indian Ministry of He alth).
Currently, in Russia it is possible to purchase a package (28 tablets) of Sofosbuvir medicine through online stores at a price of 39,900 rubles (1 tablet will cost the consumer approximately 1,800 rubles). It is not cheap, but exactly the same packaging of the branded Sovaldi will require financial investments in the amount of 1,500,000 rubles, which is almost 35 times more expensive than the cost of any generic.
It is not yet possible to buy this medicine through pharmacy chains, because the process of certification of new medicines in Russia is quite lengthy.
The opinion of consumers and doctors
The drug was taken by patients with different hepatitis genotypes, different levels of fibrosis, transaminase levels significantly higher than normal and, as a rule, a high viral load.
The vast majority of patients who took the medication leave positive feedback about the Sofosbuvir drug. Those who have been treated (reviews often contain such information) earlier for hepatitis C with interferons say that the drugs cannot even be compared. Interferons cause a lot of side effects, and not all patients have the strength to endure them. As for the combination of "Sofosbuvir" and "Daklatasvir" (most often, patients talk about just such a tandem), only a small percentage of those treated with these drugs spoke about the developmentsmall negative effects in the form of dizziness, mild headaches and short-term loss of coordination. However, these manifestations cannot be compared with the side effects of Interferon and the consequences of hepatitis itself. After 2-3 weeks of therapy in many patients, the content of transaminases in the liver returns to normal. Starting from the third week of treatment with a complex of antiviral drugs "Sofosbuvir" and "Daklatasvir", in many patients the result for the presence of hepatitis C virus in the body is negative.
Also, many patients report a significant reduction in fibrosis after several months of complex therapy.
Those consumers who took a complex of three medicines - Sofosbuvir, Daclatasvir, Ribaverin - were also very satisfied with the results of the treatment.
Almost all Sofosbuvir users talk about a real breakthrough in the treatment of viral hepatitis C compared to interferon therapy. Significantly improved he alth status and quality of life of patients is direct evidence of this.
