Treatment with Sofosbuvir: reviews. "Sofosbuvir" + "Daklatasvir": expert reviews. Sofosbuvir: instructions, doctor's reviews

The liver is a kind of purifying filter for the human body. The state of this body has an impact on the functioning of many systems and on the quality of life of a person as a whole. One of the most severe liver damage is hepatitis C. Currently, many drugs have been developed to fight this disease. One of the most effective means is considered (which is confirmed by medical references), Sofosbuvir.

Indications for use

In general, cofactor is called active ingredient in tablets, and the brand itself has the trade name "Sowaldi". Thus, we can say that this medication is a cheaper substitute - the generic "Sofosbuvir", whose reviews describe the drug as one of the most effective drugs for the treatment of viral hepatitis C. This is its main area of application.

The main substance, sophosbuvir, is an inhibitor of the viral polymerase NS5B, that is, it suppresses the process of reproduction of the hepatitis C virus. However, most medical specialists do not recommend Sofosbuvir monotherapy (although this is possible in principle). But as the main active component of complex antiviral therapy, the drug "Sofosbuvir" reviews have only positive direction, characterizing it as a highly effective remedy. According to the clinical studies, the drug in tandem with other medicines showed excellent results in relation to the treatment of the hepatitis C virus (genotypes 1, 2, 3).

The treatment of Sofosbuvir with health workers is characterized positively not only for patients who have never been treated, but also for those who have previously received antiviral therapy with other drugs and after the treatment, after a period of relapse.

In addition to the above described area of exposure, "Sofosbuvir" reviews physicians and recommendations instructions allow the use in the therapy of patients suffering from cirrhosis of the liver.

As for the effectiveness of the drug for co-infection with HIV and hepatitis (a fairly common situation), such information is currently not 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 treatment of hepatitis C "Sovvaldi" (or "Sofosbuvir"), whose reviews are positive, like any modern highly effective medicine, has certain contraindications for use.

First, it is an individual hypersensitivity to the main and auxiliary components of the drug. Women who are of childbearing age should be cautious when using it. In particular, if "Sowaldi" ("Sofosbuvir") is prescribed in conjunction with "Ribavirin" and "Interferon alfa" (actual for genotypes 3, 4, 5, 6, hepatitis), it should be in all possible ways to avoid pregnancy. It is also very undesirable to carry out treatment with these drugs during the course of pregnancy and during lactation.

At present, there is no information about the influence of Sofosbuvir on the reproductive function of man. There is also no information on the safety and efficacy of the drug in patients under 18 years of age.

Methods and duration of therapy

First, it should be stipulated that antiviral therapy is allowed only for those medical professionals who have sufficient experience in treating patients with hepatitis C. The standard regimen is 1 tablet (400 mg of active ingredient) during the day during any period of food intake. Since the tablets are bitter (such are the responses from the medicines that received the medication), "Sofosbuvir" should be swallowed without chewing and not breaking it.

If the tablet was taken, and after that within the next 2 hours, vomiting started, it is recommended to take 1 more tablet. If vomiting develops after a period of time greater than 2 hours, no additional dose is needed.

If the next intake of the drug for any reason was missed (the delay period is not more than 18 hours), it is recommended to take the missed dose, and then continue the 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 for the treatment of hepatitis C, along with "Sofosbuvir", the practice of the appointment of "Ribavirin", "Interferon alfa", "Daklatasvira", "Ladipasvira", "Asunaprevir".

In general, tandem "Sofosbuvir" + "Daklatasvir" reviews of health workers and patients are characterized as effective for fighting hepatitis C genotypes 1,2,3.

To date, "Daklataswir" can be ordered on the WWW.ARV24.COM website with delivery in hand - in a company that has a long-standing reputation. Provided that the hands have all the necessary information about the presence of the disease.

Genotypes 4, 5, 6 are treated with a complex of medicines "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, Sofosbuvir with Ribavirin is prescribed for admission for 24 weeks.

Tandem "Ribavirin" with the drug "Sofosbuvir" for the 2 genotype reviews of experts also characterize as the most effective combination, which is appointed 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 the 3 genotype 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 a patient suffers from hepatocarcinoma and / or expects an operation for liver transplantation, the practice of "Sofosbuvira" in combination with "Ribavirin" is practiced for 48 weeks or until surgical intervention for organ transplantation. This is important in order to prevent infection of the liver after transplantation.

Clinical studies suggest that the combined use of Sofosbuvir with other drugs can produce a consistently positive virologic response in 92% of cases of complex therapy in the treatment of viral hepatitis C.

Possible side effects

In the process of conducting clinical trials, the drug was tolerated very well by patients (such was their feedback). "Sofosbuvir" causes side effects in most cases when used in combination with "Ribavirin" and "Interferon".

When combining Sofosbuvira with Ribavirin, the concentration of hemoglobin decreases in the blood composition more often (more than 10% of cases) and bilirubin levels increase, fatigue, irritability and insomnia, nausea may occur.

Less often (less than 10% of cases), this combination of drugs provokes depression, anemia, rhinopharyngitis, attention deficit disorder, dyspepsia, constipation and intestinal disorders, allergic manifestations on the skin (itching, rashes). Sometimes patients leave such comments: "Sofosbuvir", used in parallel with "Ribavirin", caused hair loss and back pain, seizures, myalgia and asthenia.

If a complex of three medicines is used (the "Interferon-alpha" is added to the two above mentioned), a much wider list of adverse events is very often (more than 10% of cases). Here they talk about changes in the blood composition: a decrease in the number of lymphocytes, platelets and neutrophils, anemia, an increase in the level of bilirubin. From the digestive tract can develop diarrhea, nausea, vomiting. In addition, Sofosbuvir (instructions, reviews of patients and health workers confirm) can provoke headaches and dizziness, coughing, shortness of breath, itching and rash, myalgia and joint pain. Often patients talk about fatigue, irritability, chills, fever.

Less often (from 1 to 10%) patients speak about fears and development of depression, about weight loss, about memory and concentration abnormalities, about migraines. There is information on the deterioration of vision, hair loss, the development of reflux and dyspnea with increased load. Sometimes patients talk about pain in the back and chest, convulsions and asthenia.

What do I need to know?

If the patient has one or more negative factors - initially high viral load, progressive fibrosis, too dark skin, then Sofosbuvir treatment (expert reviews and instructions for use confirm) can be increased for up to 24 weeks. When combined therapy is used, the effective dose of "Ribavirin" is selected in accordance with the patient's body weight, ie 75 kg of body weight requires 1.2 g of medicament. The entire volume of the drug is divided into two parts and taken with food.

It is not recommended to reduce the dosage of "Sofosbuvira".

If the joint manifestations of Solfosbuvir and Interferon alfa develop negative manifestations characteristic of the last drug, the taken dose of Interferon requires reducing or completely canceling the medication (detailed instructions on dose reduction or drug cancellation are available in special instructions).

It is exactly the same when a combination of "Sofosbuvira" with "Ribavirin" is applied, and negative effects develop on the reception of the latter - the dose decreases or the reception of "Ribavirin" completely ceases. After the results of blood tests improve, it is permissible to try to resume taking Ribavirin, starting from 600 mg and gradually increasing to 800 mg. It is not recommended to increase the dose to the originally prescribed dose.

If you cancel one of the complex therapy medications, you should stop taking "Sofosbuvir" completely - the specialists' comments and instruction instructions for use in this matter are the same.

Interaction with other substances

Medical workers do not recommend patients in parallel with the drug in question to use other antiviral drugs (other than those prescribed by the attending physician) during the period when hepatitis is treated. "Sofosbuvir" reviews of specialists consider it possible to combine with something else only in those cases when the expected benefit from a combination of drugs exceeds the possible risk of unwanted effects.

There are also groups of drugs, the joint use of which with Sofosbuvir can significantly reduce its absorption ("Sofosbuvira") in the intestine. To such medicines - from anticonvulsants - it is possible to carry "Phenytoin", "Phenobarbital", "Carbamazepine" and "Oxcarbazepine". The antimycobacterial group of medicines also contains such drugs: Rifabutin, Rifampicin, Rifapentin. Of herbal supplements, it is possible to significantly reduce the absorption of Sofosbuvira by St. John's Wort. It is also not recommended to combine the drug with HIV protease inhibitors: "Tipranavir", "Ritonavir".

Special instructions

Only the attending physician has the right to choose the treatment regimen for hepatitis C and medications that will be prescribed for treatment: "Ladipasvir", "Asunaprevir", "Sofosbuvir", "Daklatasvir". The patients' reviews of all the generals of "Sovvaldi" are positive.

However, it should be borne in mind that for patients with severe forms of renal failure, the volume of the dose should be selected specifically. There is no need to recalculate the dosage for those who suffer from mild and moderate pathology. As for hepatic insufficiency, there is no need to adjust the dose for patients with any degree of severity of the disease.

In the treatment of hepatitis C with the use of combination therapy on the basis of "Sofosbuvira" it is not recommended to engage in those activities that require high concentration of attention and speed of psychomotor reactions.

Price range

The cost of branded medicines in Germany ranges from 18 to 20 thousand euros. And to purchase it, even at this price, you will need a prescription from the treating doctor. Such a high cost is due to the fact that the developer company should recoup all its expenses for scientific research, development and testing of medicines.

It is much cheaper to cost the consumer generics medicines (cheaper analogues of the brand with an absolutely identical active ingredient). These include "Daklatasvir", "Asunaprevir", "Ladipasvir" and "Sofosbuvir". The consumers' reviews contain information about the high cost of these medicines, but it is not about tens of thousands of euros.

Starting in March 2015, according to the license of the developer company, the release of Sofosbuvira began by the Indian pharmaceutical company Natko (naturally, with the permission of the Ministry of Health of India).

At present, in Russia it is really possible to buy a package (28 tablets) of the medication "Sofosbuvir" at the price of 39 900 rubles (1 tablet will cost about 1800 rubles). This is not cheap, but exactly the same packaging branded "Sowaldi" will require financial investments in the amount of 1,500,000 rubles, which is almost 35 times more expensive than any generic.

Through pharmacy chains, there is no way to buy this medicine, since the process of certification of new medicines in Russia is quite long.

Opinion of consumers and doctors

The drug was taken by patients with different hepatitis genotypes, different levels of fibrosis, with transaminases significantly higher than normal and, as a rule, high viral load.

The overwhelming majority of patients taking the drug leave positive comments about the Sofosbuvir drug. Who was treated (reviews often contain such information) earlier from hepatitis C interferons, suggests that drugs can not even be compared. Interferons cause a lot of side effects, and not all patients have enough strength to bear them. As for the combination of Sofosbuvir and Daklatasvir (most patients talk about this tandem), only a small percentage of those treated with these drugs spoke about the development of small negative effects in the form of dizziness, mild headaches and short-term loss of coordination. However, these manifestations can not be compared with the side effects of Interferon and the consequences of hepatitis itself. After 2-3 weeks of therapy, the content of transaminases in the liver comes to normal in many patients. Since the third week of treatment with a complex of antiviral drugs "Sofosbuvir" and "Daklatasvir" in many patients, the result for the presence of the hepatitis C virus in the body is negative.

Also, very many patients report a significant reduction in fibrosis after several months of complex therapy.

Those consumers who took a complex of three medicines - Sofosbuvir, Daklatasvir, and Ribaverine - also were very pleased with the results of the treatment.

Almost all consumers of Sofosbuvir talk about a real breakthrough in the treatment of viral hepatitis C compared to interferon therapy. Significantly improved health and quality of life of patients - that's direct proof.