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reversibility of which is uncertain—if possible, consider

starting treatment after pubertal growth spurt (in children)

. severe dental disorders (in adults). severe ocular

disorders (in adults). severe periodontal disorders (in

adults). severe psychiatric effects (in adults)

l INTERACTIONS → Appendix 1: ribavirin

l SIDE-EFFECTS

▶ Common or very common Alopecia . anaemia . anxiety . appetite decreased . arrhythmias . arthralgia . arthritis . asthenia . behaviour abnormal . chest pain . chills . concentration impaired . constipation . cough . depression . diarrhoea . dizziness . drowsiness . dry mouth . dysphagia . dyspnoea . ear pain . eye disorders . eye inflammation . eye

pain . fever. gastrointestinal discomfort. gastrointestinal

disorders . haemorrhage . headaches . hyperthyroidism . hypotension . hypothyroidism . increased risk of infection . influenza like illness . lymphadenopathy . malaise . memory loss . mood altered . muscle complaints . muscle

weakness . nasal congestion . nausea . neutropenia . oral

disorders . pain . palpitations . peripheral oedema . photosensitivity reaction .respiratory disorders . sensation

abnormal . sexual dysfunction . skin reactions . sleep

disorders . sweat changes . syncope .taste altered .thirst. throat pain .thrombocytopenia .tinnitus .tremor. vasodilation . vertigo . vision disorders . vomiting . weight

decreased

▶ Uncommon Dehydration . diabetes mellitus . hallucination . hearing loss . hepatic disorders . hypertension . nerve

disorders . sarcoidosis . suicidal tendencies .thyroiditis

▶ Rare or very rare Angina pectoris . angioedema . bone

marrow disorders . cardiac inflammation . cerebral

ischaemia . cholangitis . coma . congestive heart failure . facial paralysis . hepatic failure (discontinue). hypersensitivity . intracranial haemorrhage . myocardial

infarction . myopathy . pancreatitis . psychotic disorder. pulmonary embolism .retinopathy . seizure . severe

cutaneous adverse reactions (SCARs). systemic lupus

erythematosus (SLE) . vasculitis

▶ Frequency not known Haemolytic anaemia . homicidal

ideation . nephrotic syndrome . pure red cell aplasia .renal

failure . solid organ transplant rejection .tongue

discolouration . ulcerative colitis

SIDE-EFFECTS, FURTHER INFORMATION Side effects listed

are reported when oral ribavirin is used in combination

with peginterferon alfa or interferon alfa, consult product

literature for details.

l CONCEPTION AND CONTRACEPTION

▶ With systemic use Exclude pregnancy before treatment in

females of childbearing age. Effective contraception

essential during treatment and for 4 months after

treatment in females and for 7 months after treatment in

males of childbearing age. Routine monthly pregnancy

tests recommended. Condoms must be used if partner of

male patient is pregnant (ribavirin excreted in semen).

▶ When used by inhalation Women planning pregnancy should

avoid exposure to aerosol.

l PREGNANCY Avoid; teratogenicity in animal studies.

▶ When used by inhalation Pregnant women should avoid

exposure to aerosol.

l BREAST FEEDING Avoid—no information available.

l HEPATIC IMPAIRMENT Avoid oral ribavirin in severe

hepatic dysfunction or decompensated cirrhosis.

Dose adjustments No dosage adjustment required.

l RENAL IMPAIRMENT Plasma-ribavirin concentration

increased.

▶ In adults Manufacturer advises avoid oral ribavirin unless

essential if eGFR less than 50 mL/minute/1.73 m2

monitor haemoglobin concentration closely.

▶ In children Manufacturer advises avoid oral ribavirin if

estimated glomerular filtration rate less than

50 mL/minute/1.73 m2

—monitor haemoglobin

concentration closely. Manufacturer advises use

intravenous preparation with caution if estimated

glomerular filtration rate less than 30 mL/minute/1.73 m2

.

l MONITORING REQUIREMENTS

▶ When used by inhalation Monitor electrolytes closely.

Monitor equipment for precipitation.

▶ With systemic use in children Determine full blood count,

platelets, electrolytes, serum creatinine, liver function

tests and uric acid before starting treatment and then on

weeks 2 and 4 of treatment, then as indicated clinically—

adjust dose if adverse reactions or laboratory

abnormalities develop (consult product literature).

▶ With systemic use in adults Determine full blood count,

platelets, electrolytes, glucose, serum creatinine, liver

function tests and uric acid before starting treatment and

then on weeks 2 and 4 of treatment, then as indicated

clinically—adjust dose if adverse reactions or laboratory

abnormalities develop (consult product literature).

▶ With systemic use in children Test thyroid function before

treatment and then every 3 months.

▶ With oral use in children Eye examination recommended

before treatment. Eye examination also recommended

during treatment if pre-existing ophthalmological disorder

or if decrease in vision reported—discontinue treatment if

ophthalmological disorder deteriorates or if new

ophthalmological disorder develops.

l PRESCRIBING AND DISPENSING INFORMATION Flavours of

oral liquid formulations may include bubble-gum.

l NATIONAL FUNDING/ACCESS DECISIONS

NICE decisions

▶ Peginterferon alfa and ribavirin for mild chronic hepatitis C

(August 2006 and September 2010) NICE TA200

▶ In adults The combination of peginterferon alfa and

ribavirin can be used for treating mild chronic hepatitis C

in patients over 18 years. Alternatively, treatment can be

delayed until the disease has reached a moderate stage

(‘watchful waiting’).

www.nice.org.uk/TA200

▶ Peginterferon alfa, interferon alfa, and ribavirin for moderate

to severe chronic hepatitis C (January 2004 and September

2010) NICE TA200

▶ In adults The combination of peginterferon alfa and

ribavirin should be used for treating moderate to severe

chronic hepatitis C in patients aged over 18 years:.

. not previously treated with interferon alfa or

peginterferon alfa;

. treated previously with interferon alfa alone or in

combination with ribavirin;

. whose condition did not respond to peginterferon alfa

alone or to a combination of peginterferon alfa and

ribavirin, or responded but subsequently relapsed;

. co-infected with HIV.

Peginterferon alfa alone should be used if ribavirin is

contra-indicated or not tolerated. Interferon alfa for either

monotherapy or combined therapy should be used only if

neutropenia and thrombocytopenia are a particular risk.

Patients receiving interferon alfa may be switched to

peginterferon alfa.

www.nice.org.uk/TA200

▶ Peginterferon alfa and ribavirin for chronic hepatitis C

(November 2013) NICE TA300

▶ In children Peginterferon alfa in combination with ribavirin

is recommended (within the marketing authorisation) as

an option for treating chronic hepatitis C in children.

www.nice.org.uk/TA300

l LESS SUITABLE FOR PRESCRIBING Ribavirin inhalation is

less suitable for prescribing.

BNF 78 Chronic hepatitis C 627

Infection

5

l MEDICINAL FORMS There can be variation in the licensing of

different medicines containing the same drug.

Solution for injection

▶ Virazole (Meda Pharmaceuticals Ltd)

Ribavirin 100 mg per 1 ml Virazole 1.2g/12ml solution for injection

vials | 5 vial P £3,600.00

Oral solution

CAUTIONARY AND ADVISORY LABELS 21

▶ Rebetol (Merck Sharp & Dohme Ltd)

Ribavirin 40 mg per 1 ml Rebetol 40mg/ml oral solution | 100 ml P £67.08

Tablet

CAUTIONARY AND ADVISORY LABELS 21

▶ Copegus (Roche Products Ltd)

Ribavirin 200 mg Copegus 200mg tablets | 112 tablet P £233.58 | 168 tablet P £350.37

Ribavirin 400 mg Copegus 400mg tablets | 56 tablet P £233.58

Capsule

CAUTIONARY AND ADVISORY LABELS 21

▶ Rebetol (Merck Sharp & Dohme Ltd)

Ribavirin 200 mg Rebetol 200mg capsules | 168 capsule P £321.38

ANTIVIRALS › NUCLEOTIDE ANALOGUES

Ledipasvir with sofosbuvir 11-Jul-2018

The properties listed below are those particular to the

combination only. For the properties of the components

please consider, sofosbuvir below.

l DRUG ACTION Sofosbuvir is a nucleotide analogue

inhibitor and ledipasvir is an HCV inhibitor; they reduce

viral load by inhibiting hepatitis C virus RNA replication.

l INDICATIONS AND DOSE

Chronic hepatitis C infection (initiated by a specialist)

▶ BY MOUTH

▶ Adult: 90/400 mg once daily, for duration of treatment

consult product literature

DOSE ADJUSTMENTS DUE TO INTERACTIONS

▶ Manufacturer advises reduce dose of concurrent H2-

receptor antagonist if above a dose comparable to

famotidine 40 mg twice daily.

▶ Manufacturer advises reduce dose of concurrent proton

pump inhibitor if above a dose comparable to

omeprazole 20 mg; take at the same time as sofosbuvir

with ledipasvir.

DOSE EQUIVALENCE AND CONVERSION

▶ Dose expressed as x/y mg ledipasvir/sofosbuvir.

l CAUTIONS Retreatment following treatment failure—

efficacy not established

l INTERACTIONS → Appendix 1: ledipasvir. sofosbuvir

l SIDE-EFFECTS

▶ Common or very common Fatigue . headache .rash

▶ Frequency not known Angioedema . arrhythmia

l PRESCRIBING AND DISPENSING INFORMATION Dispense in

original container (contains desiccant).

l PATIENT AND CARER ADVICE

Vomiting If vomiting occurs within 5 hours of

administration, an additional dose should be taken.

Missed doses If a dose is more than 18 hours late, the

missed dose should not be taken and the next dose should

be taken at the normal time.

l NATIONAL FUNDING/ACCESS DECISIONS

NICE decisions

▶ Ledipasvir–sofosbuvir for treating chronic hepatitis C

(November 2015) NICE TA363

Ledipasvir with sofosbuvir is recommended as an option

for treating adults with chronic hepatitis C infection:

. of genotype 1 without cirrhosis (treatment naive

patients)—8 weeks’ treatment

. of genotype 1 or 4 with cirrhosis (treatment naive

patients)—12 weeks’ treatment

. of genotype 1 or 4 without cirrhosis (or with cirrhosis but

only if the person has a low risk of the disease getting

worse) that has not responded adequately to previous

treatment—12 weeks’ treatment

In addition, ledipasvir with sofosbuvir is only

recommended in patients with cirrhosis for the durations

mentioned above if the following criteria are met:

. Child-Pugh class A

. platelet count of 75 000/mm3 or more

. no features of portal hypertension

. no history of an HCV-associated decompensation

episode

. not previously treated with an NS5A inhibitor

Patients whose treatment with ledipasvir with sofosbuvir

is not recommended in this NICE guidance, but was started

within the NHS before this guidance was published, should

be able to continue treatment until they and their NHS

clinician consider it appropriate to stop.

www.nice.org.uk/guidance/ta363

Scottish Medicines Consortium (SMC) decisions

SMC No. 1030/15

The Scottish Medicines Consortium has advised (March

2015) that ledipasvir with sofosbuvir (Harvoni ®) is

accepted for restricted use within NHS Scotland for the

treatment of chronic hepatitis C infection of genotypes 1

and 4 only.

SMC No. 1084/15

The Scottish Medicines Consortium has advised

(September 2015) that ledipasvir with sofosbuvir

(Harvoni ®) is accepted for restricted use within NHS

Scotland for the treatment of chronic hepatitis C infection

of genotype 3 in patients who are ineligible for, or unable

to tolerate interferon.

l MEDICINAL FORMS There can be variation in the licensing of

different medicines containing the same drug.

Tablet

CAUTIONARY AND ADVISORY LABELS 25

▶ Harvoni (Gilead Sciences International Ltd) A

Ledipasvir 90 mg, Sofosbuvir 400 mg Harvoni 90mg/400mg

tablets | 28 tablet P £12,993.33

Sofosbuvir 26-Mar-2019

l INDICATIONS AND DOSE

Chronic hepatitis C infection

▶ BY MOUTH

▶ Adult: 400 mg once daily, for duration of treatment

consult product literature

IMPORTANT SAFETY INFORMATION

MHRA/CHM ADVICE: DIRECT-ACTING ANTIVIRALS TO TREAT

CHRONIC HEPATITIS C: RISK OF INTERACTION WITH VITAMIN K

ANTAGONISTS AND CHANGES IN INR (JANUARY 2017)

An EU-wide review has identified that changes in liver

function, secondary to hepatitis C treatment with directacting antivirals, may affect the efficacy of vitamin K

antagonists; the MHRA has advised that INR should be

monitored closely in patients receiving concomitant

treatment.

MHRA/CHM ADVICE: DIRECT-ACTING ANTIVIRAL INTERFERONFREE REGIMENS TO TREAT CHRONIC HEPATITIS C: RISK OF

HEPATITIS B REACTIVATION (JANUARY 2017)

An EU-wide review has concluded that direct-acting

antiviral interferon-free regimens for chronic hepatitis C

can cause hepatitis B reactivation in patients co-infected

with hepatitis B and C viruses; the MHRA recommends

to screen patients for hepatitis B before starting

treatment—patients infected with both hepatitis B and C

628 Viral infection BNF 78

Infection

5

viruses must be monitored and managed according to

current clinical guidelines.

MHRA/CHM ADVICE: DIRECT-ACTING ANTIVIRALS FOR CHRONIC

HEPATITIS C: RISK OF HYPOGLYCAEMIA IN PATIENTS WITH

DIABETES (DECEMBER 2018)

Rapid reduction in hepatitis C viral load during directacting antiviral therapy for hepatitis C may improve

glucose metabolism in patients with diabetes and result

in symptomatic hypoglycaemia if diabetic treatment is

continued at the same dose.

The MHRA advises healthcare professionals:

. to monitor glucose levels closely in patients with

diabetes during direct-acting antiviral therapy for

hepatitis C, especially within the first 3 months of

treatment and modify diabetic medication or doses

when necessary;

. to be vigilant for changes in glucose tolerance and

advise patients of the risk of hypoglycaemia;

. to inform the healthcare professional in charge of the

diabetic care of the patient when direct-acting

antiviral therapy is initiated.

l CAUTIONS

CAUTIONS, FURTHER INFORMATION Manufacturer advises

in chronic hepatitis C of genotype 1, 4, 5, or 6, only use

sofosbuvir with ribavirin dual therapy in those with

intolerance or contra-indications to peginterferon alfa

who require urgent treatment.

l INTERACTIONS → Appendix 1: sofosbuvir

l SIDE-EFFECTS

▶ Common or very common Alopecia . anaemia . anxiety . appetite decreased . arthralgia . asthenia . chest pain . chills . concentration impaired . constipation . cough . depression . diarrhoea . dizziness . dry mouth . dyspnoea . fever. gastrointestinal discomfort. gastrooesophageal

reflux disease . headaches . influenza like illness . insomnia . irritability . memory loss . muscle complaints . nasopharyngitis . nausea . neutropenia . pain . skin

reactions . vision blurred . vomiting . weight decreased

▶ Frequency not known Arrhythmia

SIDE-EFFECTS, FURTHER INFORMATION Side-effects listed

are reported when sofosbuvir is used in combination with

ribavirin or with ribavirin and peginterferon alfa.

l PREGNANCY Manufacturer advises avoid—limited

information available.

l BREAST FEEDING Manufacturer advises avoid—present in

milk in animal studies.

l RENAL IMPAIRMENT Safety and efficacy not established if

eGFR less than 30 mL/minute/1.73 m2

—accumulation may

occur.

l PRESCRIBING AND DISPENSING INFORMATION Dispense in

original container (contains desiccant).

l PATIENT AND CARER ADVICE

Missed doses Manufacturer advises if a dose is more than

18 hours late, the missed dose should not be taken and the

next dose should be taken at the normal time.

l NATIONAL FUNDING/ACCESS DECISIONS

NICE decisions

▶ Sofosbuvir for treating chronic hepatitis C (February 2015)

NICE TA330

Sofosbuvir (Sovaldi ®) in combination with peginterferon

alfa and ribavirin is an option for treating adults with

chronic hepatitis C infection:

. of genotype 1

. of genotype 3 with cirrhosis (treatment naive patients)

. of genotype 3 that has not adequately responded to

interferon-based treatment

. of genotype 4, 5, or 6 with cirrhosis.

Sofosbuvir (Sovaldi ®) in combination with ribavirin is an

option for treating adults with chronic hepatitis C

infection:

. of genotype 2 who are intolerant to or ineligible for

interferon (treatment naive patients)

. of genotype 2 that has not adequately responded to

interferon-based treatment

. of genotype 3 with cirrhosis who are intolerant to or

ineligible for interferon (treatment naive patients)

. of genotype 3 with cirrhosis that has not adequately

responded to interferon-based treatment

Patients whose treatment was started within the NHS

before this guidance was published should have the option

to continue treatment, without change to their funding

arrangements, until they and their NHS clinician consider

it appropriate to stop.

www.nice.org.uk/guidance/ta330

▶ Sofosbuvir for treating chronic hepatitis C (February 2015)

NICE TA330

Sofosbuvir (Sovaldi ®) in combination with ribavirin is not

recommended for the treatment of adults with chronic

hepatitis C infection of genotypes 1, 4, 5, or 6.

Patients whose treatment was started within the NHS

before this guidance was published should have the option

to continue treatment, without change to their funding

arrangements, until they and their NHS clinician consider

it appropriate to stop.

www.nice.org.uk/guidance/ta330

Scottish Medicines Consortium (SMC) decisions

SMC No. 964/14

The Scottish Medicines Consortium has advised (June 2014)

that sofosbuvir (Sovaldi ®) is accepted for restricted use

within NHS Scotland for the treatment of chronic hepatitis

C infection of genotypes 1 to 6; its use in combination with

ribavirin as dual therapy for chronic hepatitis C infection

of either genotype 2 (in treatment naive patients) or

genotype 3 is restricted to those who cannot use

peginterferon alfa because of intolerance or contraindications.

l MEDICINAL FORMS There can be variation in the licensing of

different medicines containing the same drug.

Tablet

CAUTIONARY AND ADVISORY LABELS 21, 25

▶ Sovaldi (Gilead Sciences International Ltd) A

Sofosbuvir 400 mg Sovaldi 400mg tablets | 28 tablet P £11,660.98

Sofosbuvir with velpatasvir 24-Jul-2017

The properties listed below are those particular to the

combination only. For the properties of the components

please consider, sofosbuvir p. 628.

l DRUG ACTION Sofosbuvir is a nucleotide analogue

inhibitor and velpatasvir is an HCV inhibitor; they reduce

viral load by inhibiting hepatitis C virus RNA replication.

l INDICATIONS AND DOSE

Chronic hepatitis C infection, with or without ribavirin

(initiated by a specialist)

▶ BY MOUTH

▶ Adult: 400/100 mg once daily for 12 weeks (may extend

to 24 weeks in some circumstances—consult product

literature)

DOSE ADJUSTMENTS DUE TO INTERACTIONS

▶ Manufacturer advises reduce dose of concurrent H2-

receptor antagonist if above a dose comparable to

famotidine 40 mg twice daily.

▶ Manufacturer advises reduce dose of concurrent proton

pump inhibitor if above a dose comparable to

continued→

BNF 78 Chronic hepatitis C 629

Infection

5

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