Duvir

Introduction
Duvir is a combination of two antiviral medicines. This prescription medicine is used in the treatment of chronic hepatitis C virus (HCV) infection. It fights against the viruses to resolve the infection. Duvir should be taken in the prescribed dose and duration. It can be taken with or without food, but take it at the same time daily. It is advised not to consume more than the recommended dose. It is important to inform your doctor if you have any health conditions such as liver or kidney disease. It is harmful to consume alcohol along with this medicine, so it is advised to limit or avoid alcohol. The course of the medicine should be completed for better results. The common side effects of this medicine are tiredness and headache. You should drink plenty of fluid and eat a healthy diet to prevent or overcome the side effects. Before taking the medicine, inform your doctor if you are taking any other medicines or supplements.

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Uses of Duvir
Chronic hepatitis C virus (HCV) infection
Side effects of Duvir
Common
Tiredness
Headache
How to use Duvir
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Duvir may be taken with or without food, but it is better to take it at a fixed time.
How Duvir works
Duvir is a combination of two antiviral medicines: Ledipasvir and Sofosbuvir. They work by lowering the amount of hepatitis C virus in the body and removing the virus from the blood over a period of time.
Quick Tips
Duvir is used for the treatment of chronic hepatitis C virus (HCV) infection.
Take it with food, preferably at the same time everyday.
You will usually need to take this medicine every day for either 12 or 24 weeks.
Skipping doses increases the risk of treatment failure. Make sure that you take all your doses at the correct time.
It may cause fatigue, dizziness, and blurred vision. Don’t drive or do anything requiring concentration until you know how it affects you.
Duvir may cause headaches. Drink plenty of water and take a suitable painkiller. Inform your doctor if it does not go away.
Your doctor may monitor your liver function and the amount of hepatitis C virus in your body regularly.
Do not stop taking this medicine without your doctor’s advice.
Brief Description
Indication
Chronic hepatitis C (CHC), genotype 1, 4 & 6 infection in adults.

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Administration
Can be taken with or without food.
Adult Dose
Oral Hepatitis C Indicated for adults with chronic hepatitis C virus (HCV) genotypes 1, 4, 5, or 6 infection Recommended dosage: One tablet (90 mg of Ledipasvir and 400 mg of Sofosbuvir) taken once daily. Recommended treatment duration: Treatment-naive with or without cirrhosis: 12 weeks Treatment-experienced without cirrhosis: 12 weeks Treatment-experienced with cirrhosis: 24 weeks Hepatic impairment Mild, moderate, or severe: No dosage adjustment required Decompensated cirrhosis: Safety and efficacy not established

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Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment Mild or moderate: No dosage adjustment required Severe (eGFR <30 mL/min/1.73 m²) or ESRD: No dosage recommendation can be given _ Contraindication Hypersensitivity. Mode of Action Ledipasvir is an HCV NS5A inhibitor and Sofosbuvir is a nucleotide analog inhibitor of HCV NS5B polymerase. Ledipasvir is a potent inhibitor of HCV NS5A, a viral phosphoprotein that plays an important role in viral replication, assembly, and secretion. Sofosbuvir is a nucleotide analog inhibitor of hepatitis C virus NS5B polymerase—the key enzyme mediating HCV RNA replication. The triphosphate form of sofosbuvir (GS-461203) mimics the natural cellular uridine nucleotide and is incorporated by the HCV RNA polymerase into the elongating RNA primer strand, resulting in chain termination. _ Precaution Bradycardia with Amiodarone coadministration: Serious symptomatic bradycardia may occur in patients taking Amiodarone, particularly in patients also receiving beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease. Coadministration of Amiodarone with Ledipasvir and Sofosbuvir combination is not recommended. In patients without viable treatment options, cardiac monitoring is recommended. Lactation: Unknown if distributed in human breast milk _ Side Effect >10% Asthenia (31-36%),Fatigue (4-18%),Headache (13-29%),Cough (5-11%) 1-10% Nausea (6-9%),Diarrhea (3-7%),Dizziness (1-5%),Dyspnea (3-9%),Insomnia (3-6%),Increased bilirubin >1.5 x ULN (<1 to 3%),Increased lipase >3 x ULN (<1 to 3%),Myalgia (4-9%),Irritability (7-8%) Frequency Not Defined Asymptomatic creatine kinase elevation, Grades 3/4 _ Interaction Reduced therapeutic effect w/ drugs that are potent P-gp inducers in the intestine (eg rifampicin, St. John's wort, carbamazepine & phenytoin), modafinil, phenobarb/oxcarbazepine, rifabutin/rifapentine. P-gp &/or BCRP inhibitors. May result in serious symptomatic bradycardia when co-administered w/ amiodarone in combination w/ another direct acting antiviral. _