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Harvoni vs. Sovaldi: A Side-by-Side Comparison

Introduction

Hepatitis C is a liver disease caused by infection with the hepatitis C virus (HCV). The disease ranges in severity. Some people have it for several weeks or months  and then get better. This is called acute HCV infection.  However, some people have it for several years or even a lifetime. This is called chronic HCV infection. Chronic HCV infections require treatment. You may develop serious liver problems if you don’t treat a chronic HCV infection. These problems include liver cancer or cirrhosis (liver scarring).

There are six types of hepatitis C viruses. They are grouped by their genotype (genetic makeup). Not all hepatitis C drugs treat infections from all HCV genotypes. When deciding how to treat your hepatitis C, your doctor will consider what type of HCV infection you have.

Harvoni and Sovaldi are two popular prescription drugs that are used to treat hepatitis C. They are brand-name drugs. Harvoni is a brand name for a drug that combines two drugs (ledipasvir and sofosbuvir) in one tablet. It is used by itself. Sovaldi is a brand name for the drug sofosbuvir. It is used in combination with other drugs. Both Harvoni and Sovaldi work by attacking HCV and stopping the virus from making copies of itself.  This is what helps get rid of the infection.

Neither of these drugs is used to treat all types of HCV infection, and it isn’t known if either of these drugs helps prevent the spread of HCV infection.

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Harvoni vs. Sovaldi

Harvoni and Sovaldi Comparisons

Harvoni Sovaldi
Use Treatment of infection with HCV genotype 1, 4, 5, or 6 Treatment with other antiviral drugs of infection with HCV genotype 1, 2, 3, or 4
Available as generic drug No No
Strength 90 mg of ledipasvir and 400 mg of sofosbuvir 400 mg of sofosbuvir
Route Taken by mouth Taken by mouth
Dose frequency Once per day Once per day
Length of treatment 12–24 weeks, depending on disease severity 12–24 weeks, depending on virus genotype
Storage Store at room temperature below 86°F (30°C). Keep the medication in its original container.
 

Cost and Availability

Cost, Insurance Coverage, and Availability

Harvoni is typically more expensive than Sovaldi. Harvoni combines the drug found in Sovaldi (sofosbuvir) with another drug (ledipasvir) in one tablet. Sovaldi only contains sofosbuvir. It must be taken with other drugs. This increases the total cost of treatment.

Both of these drugs are covered by most insurance plans. Your doctor may need to get approval from your insurance company before you can fill your prescription.

Not every pharmacy carries these drugs. Check with your pharmacy to see if it carries these drugs. You may have to get these drugs through a mail-order or specialty pharmacy.

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Side Effects

Side Effects

Harvoni and Sovaldi (when used with ribavirin or ribavirin and pegylated interferon) can both cause the more common side effects tiredness and headache. Harvoni can also cause weakness. Sovaldi with ribavirin and pegylated interferon may also cause:

  • nausea
  • trouble sleeping
  • fewer red blood cells

These drugs can also both cause slow heart rate, a serious side effect. This effect can happen with Harvoni if you also take amiodarone for heart rhythm problems. It can happen with Sovaldi when taken with pegylated interferon and used with amiodarone for heart rhythm problems.

Warnings

Interactions

Both Harvoni and Sovaldi have similar interactions with other drugs, including:

  • amiodarone
  • rifampin (used to treat tuberculosis)
  • St. John’s wort (used for depression)
  • certain seizure drugs (such as oxcarbazepine)
  • certain HIV drugs (such as tenofovir)
  • certain antacids (such as calcium tablets, Maalox, Mylanta, Rolaids)

The interaction with amiodarone can cause a severely slowed heart rate. Some HIV drugs may increase the amount of hepatitis C drug in your blood, which can lead to increased side effects. The other interacting drugs can decrease the amount of hepatitis C drug in your blood, which may make the hepatitis C drug stop working. In particular, you should not use antacids such as calcium tablets, Maalox, Mylanta, and Rolaids while taking Harvoni.

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Pregnancy and Breastfeeding

Risks While Pregnant or Breastfeeding

The risk of these drugs to a developing fetus is not known. Tell your doctor if you’re pregnant or plan to become pregnant. Your doctor should only prescribe Harvoni or Sovaldi during your pregnancy if the potential benefit justifies the potential risk to the fetus.

It is also not known if Harvoni or Sovaldi passes into breast milk. Talk to your doctor if you breastfeed your child. You may need to choose between breastfeeding and taking one of these drugs.

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Other Considerations

Use with Other Medical Conditions

You and your doctor must consider other medical conditions you have before you take either of these drugs. The effects of Harvoni and Sovaldi on other conditions are very similar:

Kidney disease

Your kidneys help remove Harvoni or Sovaldi from your body. If you have kidney disease, your kidneys can’t remove the drug as quickly as they should. This could lead to a buildup of the drug in your body. A buildup can increase your chance of side effects. Your doctor may need to adjust your dose of Harvoni or Sovaldi.

Liver disease

Your liver helps break down Harvoni or Sovaldi. If you have severe liver disease or have recently had a liver transplant, your liver might not be able to break down the drugs as quickly as it should. This could cause the drug to build up in your body. A buildup can increase your risk of side effects. Your doctor may need to adjust your dose of Harvoni or Sovaldi.

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Effectiveness

Side by Side: Effectiveness

The effectiveness of these drugs is measured by how much of the virus is still in your blood after your treatment ends. The goal is to have so few copies of the virus in your blood that lab tests can’t detect the virus.

Harvoni and Sovaldi are very effective. The following table shows the percentage of people who had undetectable HCV levels in their blood for 12 or more weeks after the end of their treatment.

Type of hepatitis C virus Harvoni Sovaldi*
Genotype 1 96–99% 76–90%
Genotype 2 NA 78–95%
Genotype 3 NA 84–92%
Genotype 4 93–100% 90%
Genotype 5 93% NA
Genotype 6 96% NA
 
Abbreviation: NA= not applicable
*When taken with the drugs pegylated interferon or ribavirin or both

Takeaway

Talk with Your Doctor

Ask your doctor for more information about Harvoni and Sovaldi. Be sure to share your medical history. Your doctor can help you decide on a treatment that’s both effective and appropriate for your specific health needs.

Article resources
  • U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2015). Hepatitis C: General information. Retrieved from
  • Gilead Sciences, Inc. (2015, November). Harvoni (ledipasvir and sofosbuvir) tablets, for oral use [package insert]. Foster City, CA.
  • Gilead Sciences, Inc. (2015, August). Sovaldi (sofosbuvir) tablets, for oral use [package insert]. Foster City, CA.
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