HARVONI VS. MAVYRET
Here we look at how Harvoni and Mavyret are alike and different.
Harvoni contains two drugs in one pill: ledipasvir and sofosbuvir. Mavyret also contains two drugs in one pill: glecaprevir and pibrentasvir.
Harvoni and Mavyret are both approved by the FDA to treat hepatitis C. However, they’re used to treat different genotypes in varying situations:
- Harvoni is approved to treat hepatitis C genotypes 1, 4, 5, and 6. Mavyret is approved to treat all six main genotypes.
- Both medications are used to treat people who have compensated cirrhosis. Harvoni can also be used in people with decompensated cirrhosis, but Mavyret can’t.
- Both can be used in people who have had a liver transplant.
- Mavyret can be used in people with severe kidney disease or after a kidney transplant, but Harvoni isn’t approved for these uses.
- Harvoni is approved to treat hepatitis C in children ages 12 and older or who weigh at least 77 pounds. Mavyret is only approved for use in adults.
- Both medications are approved to treat people who’ve tried certain hepatitis C medications in the past.
Drug forms and administration
Harvoni and Mavyret both come as tablets you take once per day. However, while you take one Harvoni tablet per day, you take three Mavyret tablets per day.
Harvoni can be taken with or without food, but Mavyret should be taken with a meal.
Harvoni may be prescribed for 8, 12, or 24 weeks of treatment. Mavyret’s treatment duration may be 8, 12, or 16 weeks. The length of treatment your doctor prescribes will be based on your hepatitis C genotype, liver function, and history of past hepatitis C treatments.
Side effects and risks
Harvoni and Mavyret have similar effects on the body. This means they also cause similar side effects. Below are examples of some of these side effects.
More common side effects
These lists contain examples of more common side effects that can occur with Mavyret, with Harvoni, or with both drugs (when taken individually).
- Can occur with Harvoni:
- feeling weak
- insomnia (trouble sleeping)
- feeling irritable
- Can occur with Mavyret:
- elevated bilirubin level (a lab test that checks your liver function)
- Can occur with both Harvoni and Mavyret:
- feeling tired
Serious side effects
Serious side effects that can occur with both Harvoni and Mavyret include:
- hepatitis B reactivation (when a previous infection becomes active again), which can lead to severe liver damage, liver failure, or death (see “Boxed warnings” below)
- serious allergic reaction, with symptoms that can include trouble breathing and angioedema (swelling under your skin, typically in your eyelids, lips, hands, or feet)
Harvoni and Mavyret both have boxed warnings from the FDA. A boxed warning is the strongest warning the FDA requires.
The warning describes a risk of hepatitis B reactivation after starting treatment with either drug. Hepatitis B reactivation can lead to serious liver damage, liver failure, or death.
Your doctor will test you for hepatitis B before you start taking Harvoni or Mavyret. If you test positive for hepatitis B, you may need to take medication to treat it.
Harvoni and Mavyret haven’t been compared in clinical studies, but both are effective for treating hepatitis C.
According to treatment guidelines, Harvoni and Mavyret are both first-choice treatment options for hepatitis C genotypes 1, 4, 5, and 6. Mavyret is also a first-choice option for genotypes 2 and 3. In addition to these considerations, there are certain medical conditions where one drug would be recommended over the other:
- Children ages 12 and older or who weigh 77 pounds or more: Harvoni is a first-choice option for treating these children with genotypes 1, 4, 5, and 6. Mavyret isn’t recommended for use in children.
- Severe kidney disease: Mavyret is a first-choice option for treating hepatitis C in people with this condition. Harvoni isn’t recommended for people with severe kidney disease.
- Decompensated cirrhosis: For people with decompensated cirrhosis, Harvoni is recommended to be used with ribavirin. Mavyret isn’t recommended for people with this condition.
- Kidney transplant: For people who’ve received a kidney transplant, both drugs are recommended as a first-line option for people with genotypes 1 or 4. (Harvoni is used off-label for this purpose.) Mavyret is also recommended for people with genotypes 2, 3, 5, or 6 who’ve had a kidney transplant, but Harvoni isn’t.
- Liver transplant: Treatment recommendations for use of Harvoni and Mavyret are different for people with a liver transplant. They are based on genotype and liver function.
Harvoni and Mavyret are both brand-name medications. Brand-name medications usually cost more than generics.
Note: A generic version of Harvoni was released in early 2019. The manufacturer estimates the cost for a course of the drug is approximately $24,000. This price is considerably less than the price of the brand-name version.