Brand Names of Hepatitis C Treatments
Fixed-Dose Combination Products
The most commonly used brand-name hepatitis C medications are single-tablet fixed-dose combinations that simplify treatment and improve adherence.
Pangenotypic Regimens (All Genotypes)
- Epclusa (sofosbuvir/velpatasvir) is a once-daily single tablet containing 400 mg sofosbuvir and 100 mg velpatasvir, approved for all HCV genotypes 1, 2
- Mavyret (glecaprevir/pibrentasvir) is a once-daily regimen (three tablets) effective across all genotypes, typically given for 8-16 weeks depending on cirrhosis status and treatment history 3, 2
- Vosevi (sofosbuvir/velpatasvir/voxilaprevir) is a triple-combination single tablet reserved for treatment-experienced patients, particularly those with prior DAA failure 3, 2
Genotype-Specific Regimens
- Harvoni (ledipasvir/sofosbuvir) is a single-tablet combination containing 90 mg ledipasvir and 400 mg sofosbuvir, primarily used for genotypes 1,4,5, and 6 3, 1, 2
- Zepatier (elbasvir/grazoprevir) is a once-daily single tablet used for genotypes 1 and 4, with treatment duration of 12-16 weeks depending on resistance patterns 3, 1, 2
- Viekira Pak (ombitasvir/paritaprevir/ritonavir plus dasabuvir) is a multi-tablet regimen for genotype 1, though less commonly used now due to pill burden 3, 1
Individual Component Medications
NS5B Polymerase Inhibitors
- Sovaldi (sofosbuvir) is a 400 mg once-daily nucleotide polymerase inhibitor that serves as the backbone for many combination regimens 1, 4, 5
- Daklinza (daclatasvir) is a 60 mg once-daily NS5A inhibitor used in combination with sofosbuvir, with dose adjustments required for certain HIV medications (30 mg with ritonavir-boosted protease inhibitors, 90 mg with efavirenz) 3, 1
NS3/4A Protease Inhibitors (Older Generation)
- Olysio (simeprevir) is an NS3/4A protease inhibitor that was previously combined with sofosbuvir, though this combination is no longer recommended as first-line due to lower SVR rates in real-world studies 1, 4, 5
- Incivek (telaprevir) and Victrelis (boceprevir) were first-generation protease inhibitors used with pegylated interferon and ribavirin, now obsolete due to availability of more effective and better-tolerated regimens 6, 7
Adjunctive Medications
- Ribavirin (various brands including Copegus, Rebetol) is an oral antiviral added to certain DAA regimens for patients with cirrhosis, treatment-experienced status, or specific resistance patterns, typically dosed at 1000-1200 mg daily based on weight 3, 1
- Pegylated interferon alfa (Pegasys, PegIntron) was the historical backbone of HCV therapy but is now only used in settings where DAAs are unavailable 1, 7
Key Clinical Considerations
Treatment selection should prioritize pangenotypic regimens (Epclusa or Mavyret) for most patients, as they eliminate the need for genotype testing in treatment-naïve individuals without cirrhosis 2. These modern regimens achieve SVR rates exceeding 95% across all genotypes with minimal side effects 1, 8.
Special Population Considerations
- Severe renal impairment (eGFR <30 mL/min): Zepatier or Viekira Pak are preferred because sofosbuvir-based regimens (Harvoni, Epclusa, Sovaldi) should be used with caution in this population 1
- Decompensated cirrhosis (Child-Pugh B/C): Only NS5A inhibitor combinations (Harvoni, Epclusa, or Sovaldi plus Daklinza) should be used; protease inhibitors are contraindicated 1
- HIV coinfection: All DAA regimens can be used with careful attention to drug-drug interactions with antiretroviral therapy, particularly with Daklinza which requires dose adjustment 1, 2
Generic Alternatives
Generic versions of sofosbuvir, daclatasvir, and ledipasvir are available in many countries and demonstrate equivalent efficacy to brand-name products, with SVR rates of 98% in large real-world studies 8. However, availability varies by country and regulatory approval.