EPCLUSA VS. MAVYRET
Here we look at how Epclusa and Mavyret are alike and different.
Epclusa contains two drugs in one pill: velpatasvir and sofosbuvir. Mavyret also contains two drugs in one pill: glecaprevir and pibrentasvir.
Epclusa and Mavyret are both FDA-approved to treat hepatitis C virus (HCV). They’re both used to treat all six genotypes in adults without cirrhosis or with compensated cirrhosis. However, Epclusa can also be used to treat people with decompensated cirrhosis, while Mavyret cannot.
Both medications can be used for people who are treating hepatitis C for the first time. They can also be used for people who have tried hepatitis C medications that didn’t work for them in the past.
Epclusa can be used for people who have tried any hepatitis C medication in the past. Mavyret, on the other hand, is only approved as a second treatment for people who have tried certain medications in the past. Your doctor can tell you if your past treatments make you eligible to take Mavyret.
Mavyret is also approved for use by people who have received liver or kidney transplants. Epclusa isn’t FDA-approved for use by people who have received these transplants, but in some cases, doctors may choose to prescribe the drug off-label for them.
Forms and administration
Epclusa and Mavyret both come as a single tablet that contains two drugs. You take one Epclusa tablet once daily, with or without food. You take three Mavyret tablets together once daily. Mavyret should be taken with food.
Epclusa is taken for 12 weeks, while Mavyret is taken for 8, 12, or 16 weeks, depending on your medical history.
Side effects and risks
Mavyret and Epclusa do not have the same drugs in them. However, they belong to the same class of medications. Therefore, both medications can cause similar side effects. Below are examples of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Mavyret, with Epclusa, or with both drugs (when taken individually).
- Can occur with Epclusa:
- feeling weak
- insomnia (trouble sleeping)
- Can occur with Mavyret:
- elevated bilirubin level (a lab test that checks your liver function)
- Can occur with both Epclusa and Mavyret:
- feeling tired
Serious side effects
Serious side effects that can occur with both Mavyret and Epclusa (when taken individually) include the following:
- hepatitis B virus reactivation (a flare-up of the virus, if it’s already inside your body)*
- severe allergic reaction
* Mavyret and Epclusa both have a boxed warning from the FDA for hepatitis B reactivation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.
Epclusa and Mavyret haven’t been compared in clinical studies. However, both medications are highly effective at curing all genotypes of hepatitis C.
According to treatment guidelines, Epclusa and Mavyret are both first-choice options for the treatment of all six genotypes of hepatitis C. Your doctor may recommend one or the other based on your past treatment medications. The choice between the two drugs can also depend on your liver function.
In addition to these considerations, one of these drugs would be recommended over the other for certain medical conditions. These include:
- Severe chronic kidney disease: Mavyret is a first-choice option to treat hepatitis C in people with this condition. Epclusa, on the other hand, isn’t recommended for use in these people.
- Decompensated cirrhosis: For people with this condition, Epclusa can be used with ribavirin. However, Mavyret isn’t approved for people with decompensated cirrhosis.
Epclusa and Mavyret are brand-name medications. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.
Epclusa is typically more expensive than Mavyret. The actual cost you pay for either drug will depend on your insurance plan.