What should I do if I experience red swollen feet as a side effect of Epclusa (Sofosbuvir and Velpatasvir)?

Management of Red Swollen Feet as a Side Effect of Epclusa (Sofosbuvir/Velpatasvir)

If you experience red swollen feet while taking Epclusa (sofosbuvir/velpatasvir), you should contact your healthcare provider immediately as this may require medical evaluation and possible intervention while continuing your hepatitis C treatment. 1

Understanding the Side Effect

Red swollen feet during Epclusa treatment could represent several possible conditions:

• Peripheral edema (fluid retention in the lower extremities)
• Palmar-plantar erythrodysesthesia (skin reaction)
• Photosensitivity reaction
• Allergic reaction
• Vascular changes related to liver disease improvement

Immediate Steps to Take

1. Do not discontinue Epclusa without medical consultation

   • Stopping treatment prematurely can lead to treatment failure and viral resistance
   • Epclusa has high cure rates and maintaining adherence is critical 1

2. Contact your healthcare provider promptly

   • Document when symptoms started
   • Note any other associated symptoms (pain, itching, skin changes)
   • Take photos of the affected areas if possible

Medical Evaluation

Your healthcare provider will likely:

1. Assess the severity and characteristics of the swelling

   • Differentiate between fluid retention vs. inflammatory reaction
   • Check for signs of infection or allergic reaction

2. Review your medication list

   • Epclusa has known drug interactions that may contribute to side effects 1
   • Certain medications like amiodarone are contraindicated with Epclusa

3. Consider laboratory testing

   • Liver function tests to assess treatment response and rule out hepatic complications
   • Renal function tests (especially if taking tenofovir-containing medications) 1
   • Other tests based on clinical presentation

Management Approaches

For Mild to Moderate Symptoms

1. Symptomatic management

   • Elevation of feet when resting
   • Compression stockings if recommended by your provider
   • Moisturizers for dry or irritated skin 2

2. Avoid sun exposure if photosensitivity is suspected

   • Use sunscreen and protective clothing 3
   • Photosensitivity has been reported with sofosbuvir-velpatasvir treatment

3. Monitoring

   • Regular follow-up with your provider
   • Track any changes in symptoms

For Severe Symptoms

1. Possible medication adjustments

   • Your provider may consider adjusting concomitant medications
   • In rare cases, temporary interruption of Epclusa might be necessary, but this is generally avoided 1

2. Rule out serious complications

   • Severe reactions may require more intensive evaluation
   • Hospitalization may be necessary in extreme cases

Prevention and Ongoing Care

1. Maintain good hydration unless otherwise directed by your healthcare provider

2. Follow all medication instructions precisely

   • Take Epclusa at the same time each day
   • Complete the full course of treatment (typically 12 weeks) 4

3. Be vigilant about drug interactions

   • Inform all healthcare providers about your Epclusa treatment
   • Avoid starting new medications without consultation

Special Considerations

• If you have cirrhosis: Swelling may be related to underlying liver disease rather than medication side effect
• If you have kidney disease: Close monitoring is essential as some side effects may be more pronounced 1
• If you take other medications: Drug interactions with Epclusa may contribute to side effects

When to Seek Emergency Care

Seek immediate medical attention if you experience:

• Severe swelling that is rapidly worsening
• Difficulty breathing or swallowing
• Severe skin reactions (blistering, peeling)
• Signs of infection in the affected areas

Remember that completing your full course of Epclusa treatment is crucial for achieving cure of hepatitis C, so work closely with your healthcare provider to manage side effects while maintaining treatment.