Hepatitis C Blog

Greg Jefferys Hepatitis C blog deals with all the issues associated with hepatitis C

Guidelines For Taking Harvoni

Harvoni dosing

Harvoni was developed to treat Hepatitis C genotype 1. It is also effective for genotype 4.

Tips For Taking Harvoni

Here are some simple tips for taking Harvoni that will ensure that you have the best chance of curing your Hepatitis C. These guidelines for taking Harvoni apply equally to taking generic Harvoni and brand name Harvoni because both are chemically identical.

What is Harvoni

Harvoni is the combination of two drugs Sofosbuvir 400 mg plus Ledipasvir 90 mg. Harvoni was developed by Gilead sciences specifically for the treatment of Hepatitis C genotype 1, which is the most prevalent genotype of Hepatitis C in the USA and in most European countries. It is the Ledipasvir which makes Harvoni particularly effective against Hepatitis C genotype 1. If a patient does not know which genotype of Hepatitis C they are infected by, then they should not use Harvoni but should use a pan-genotype treatment such as Epclusa or Mavyret.

One of the BIG issues in the current Hep C treatment world is reducing the possibility of relapse.

Harvoni Cure Rate

About 1 in 35 people treating with Sofosbuvir 400 mg + Ledipasvir 90 mg (Harvoni) will relapse.

Why Hepatitis C treatment relapses happen is not entirely clear however I would like to shed a little light on the process and give some tips for taking Harvoni that might help make a small difference and reduce the chance of you having a relapse.

Ledipasvir is not water-soluble

The first thing to understand when you are taking Harvoni is that Ledipasvir is not a very soluble chemical. That is to say it does not dissolve easily.

Sofosbuvir is very soluble, Ledipasvir is not.

Ledipasvir relies heavily on the stomach acids to dissolve it and make and to make the whole parcel of two drugs that is Harvoni easy for the body to absorb.

No Antacids

Because Harvoni relies on stomach acid to dissolve it you must never take antacids when you are taking Harvoni. Antacids neutralize your stomach acids and then that will reduce how much Ledipasvir is dissolved and absorbed.

On the instructions that originally came with the bottle of Harvoni it says that Harvoni can be taken with or without food however recent research has shown that taking Harvoni with food is the best option.

Some simple guidelines for taking Harvoni to make sure that you get the maximum benefits from your Hep C treatment

Taking Harvoni with food

Taking Harvoni with a small amount of food is important

Why take Harvoni with food?

Harvoni is primarily absorbed in the stomach, not the intestines, so it is important that the Harvoni stays in the stomach and is completely absorbed there.

Because one of the drugs (Ledipasvir) in Harvoni is NOT water soluble having a small amount of food in the stomach will stimulate the stomach acids. The stomach acid dissolve the Ledipasvir and assist in the absorption process.

Not a large amount of food, not a huge meal, because some of the Ledipasvir is going to get caught up in the mass of food.

Also I would not suggest drinking a large amount of water right after taking your pill or to wash the Harvoni pill down.

For the same reason.

We want that Ledipasvir to hang around in some nice strong stomach acid for a while, not get washed away in a flood of H20.

No Herbal Supplements While Taking Harvoni

Some herbs will cause your liver to make enzymes, called CYP enzymes, used by the body to remove toxins from the blood are from the same family of enzymes that the body uses to remove Sofosbuvir and Ledipasvir from the blood so high CYP levels can lead to “under-dosing.

High levels of these CYP enzymes can also be caused by some drugs and herbal supplements, particularly St John’s Wort. It is wise to avoid any herbal supplements while doing Hepatitis C treatment with Harvoni as

Harvoni Side Effects

The issue of side effects from taking Harvoni is an interesting one. Firstly it should be noted that many people report zero side effects from taking Harvoni. It should also be noted that in the research trials in the testing phase of Harvoni one group of people were given Harvoni and the same number of people were given a placebo (a pill they thought was Harvoni but was not) The people taking the placebo reported similar symptoms to the people taking the real Harvoni. In other words if you expect to get side effects you probably will.

For more information about the side effects of Harvoni please click on this link for some real world stories from real people. You might also consider joining my Hepatitis C support group on Facebook. It’s a closed group and very private but you will be able to talk to people who have done their treatment with Harvoni and gone through the whole process.

All that considered the common side effects reported by people taking Harvoni include:

  • Fatigue
  • Headache
  • Nausea
  • Diarrhoea
  • Insomnia
  • Weakness

Harvoni Dose Rates

The dose rate for Harvoni is one pill per day for either 8 weeks or 12 weeks.

There is little doubt that 12 weeks treatment with Harvoni will give a higher cure rate than 8 weeks treatment however, because of the high price of Harvoni, a lot of health services will recommend 8 weeks treatment. The reason for this is simple enough, its the price of Harvoni. Twelve weeks treatment with Harvoni costs between US$54,000 and US$84,000 (depending on where it is purchased) whereas eight weeks will cost one third of those prices and will give a cure rate that is only fractionally less than 12 weeks treatment. So by reducing the treatment time the health provider reduces the cost. For more information please read this post on Hepatitis C treatment times.


So in summary:

Take your Harvoni at about the same time each day.

Take it with a small amount of food.

Don’t drink too much water immediately after taking your pill.

No antacids and its probably a good idea not to take magnesium supplement during treatment.

No Herbal Supplements

Good luck

Tips For Taking Harvoni

Greg Jefferys

Greg Jefferys


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