Introduction
Twinvir is a combination of two antiviral medicines. This prescription medicine is used in the treatment of chronic hepatitis C virus (HCV) infection. It fights against the viruses to resolve the infection.
Twinvir should be taken in the prescribed dose and duration. It can be taken with or without food, but take it at the same time daily. It is advised not to consume more than the recommended dose. It is important to inform your doctor if you have any health conditions such as liver or kidney disease. It is harmful to consume alcohol along with this medicine, so it is advised to limit or avoid alcohol. The course of the medicine should be completed for better results.
The common side effects of this medicine are tiredness and headache. You should drink plenty of fluid and eat a healthy diet to prevent or overcome the side effects. Before taking the medicine, inform your doctor if you are taking any other medicines or supplements.
Uses of Twinvir
- Chronic hepatitis C virus (HCV) infection
How to use Twinvir
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Twinvir may be taken with or without food, but it is better to take it at a fixed time.
How Twinvir works
Twinvir is a combination of two antiviral medicines: Ledipasvir and Sofosbuvir. They work by lowering the amount of hepatitis C virus in the body and removing the virus from the blood over a period of time.
Indication
Chronic hepatitis C (CHC), genotype 1, 4 & 6 infection in adults.
Administration
Can be taken with or without food.
Adult Dose
Oral
Hepatitis C
Indicated for adults with chronic hepatitis C virus (HCV) genotypes 1, 4, 5, or 6 infection
Recommended dosage: One tablet (90 mg of Ledipasvir and 400 mg of Sofosbuvir) taken once daily.
Recommended treatment duration:
Treatment-naive with or without cirrhosis: 12 weeks
Treatment-experienced without cirrhosis: 12 weeks
Treatment-experienced with cirrhosis: 24 weeks
Hepatic impairment
Mild, moderate, or severe: No dosage adjustment required
Decompensated cirrhosis: Safety and efficacy not established
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment
Mild or moderate: No dosage adjustment required
Severe (eGFR <30 mL/min/1.73 m²) or ESRD: No dosage recommendation can be given
Contraindication
Hypersensitivity.
Mode of Action
Ledipasvir is an HCV NS5A inhibitor and Sofosbuvir is a nucleotide analog inhibitor of HCV NS5B polymerase.
Ledipasvir is a potent inhibitor of HCV NS5A, a viral phosphoprotein that plays an important role in viral replication, assembly, and secretion. Sofosbuvir is a nucleotide analog inhibitor of hepatitis C virus NS5B polymerase—the key enzyme mediating HCV RNA replication. The triphosphate form of sofosbuvir (GS-461203) mimics the natural cellular uridine nucleotide and is incorporated by the HCV RNA polymerase into the elongating RNA primer strand, resulting in chain termination.
Precaution
Bradycardia with Amiodarone coadministration: Serious symptomatic bradycardia may occur in patients taking Amiodarone, particularly in patients also receiving beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease. Coadministration of Amiodarone with Ledipasvir and Sofosbuvir combination is not recommended. In patients without viable treatment options, cardiac monitoring is recommended.
Lactation: Unknown if distributed in human breast milk
Side Effect
>10%
Asthenia (31-36%),Fatigue (4-18%),Headache (13-29%),Cough (5-11%)
1-10%
Nausea (6-9%),Diarrhea (3-7%),Dizziness (1-5%),Dyspnea (3-9%),Insomnia (3-6%),Increased bilirubin >1.5 x ULN (<1 to 3%),Increased lipase >3 x ULN (<1 to 3%),Myalgia (4-9%),Irritability (7-8%)
Frequency Not Defined
Asymptomatic creatine kinase elevation, Grades 3/4
Interaction
Reduced therapeutic effect w/ drugs that are potent P-gp inducers in the intestine (eg rifampicin, St. John's wort, carbamazepine & phenytoin), modafinil, phenobarb/oxcarbazepine, rifabutin/rifapentine. P-gp &/or BCRP inhibitors. May result in serious symptomatic bradycardia when co-administered w/ amiodarone in combination w/ another direct acting antiviral.