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Ledipasvir/sofosbuvir, sold under the trade name Harvoni among others, is a medication used to treat hepatitis C. It is a combination of ledipasvir and sofosbuvir.[1] Cure rates are 94% to 99% in people infected with hepatitis C virus (HCV) genotype 1. Some evidence also supports use in HCV genotype 3 and 4.[2] It is taken daily by mouth for 8–24 weeks.[1]

It is generally well tolerated.[3] Common side effects include muscle pains, headache, nausea, rash, and cough.[1] It is unclear if use in pregnancy is safe for the baby.[1] Ledipasvir works by decreasing the activity of NS5A and sofosbuvir works by decreasing the activity of NS5B polymerase.[1]

Ledipasvir/sofosbuvir was approved for medical use in the United States in 2014.[1] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[4] The wholesale cost in the United States is about US$91,589.40 for 12 weeks as of 2016.[5] In Bangladesh this amount costs US$1,092.00.[6] Some people travel to India to get access to lower cost medication.[7]

Medical uses

Cure rates are 94% to 99% in people infected with genotype 1. It has also been evaluated for the treatment of infection with other hepatitis C genotypes, and has shown promising results in genotypes 3 and 4.[2][8][9][10]

It should not be used with amiodarone or other drugs that lower heart rate; there is a serious risk of the heart slowing or stopping when ledipasvir/sofosbuvir is used with such drugs.[8][11]