Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
EPCLUSA vs TECHNIVIE
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
EPCLUSA is a fixed-dose combination of sofosbuvir, a nucleotide analog NS5B polymerase inhibitor, and velpatasvir, an NS5A inhibitor. Sofosbuvir inhibits HCV RNA replication by acting as a chain terminator, while velpatasvir inhibits HCV replication by binding to NS5A and disrupting viral RNA replication and assembly.
Technivie is a fixed-dose combination of ombitasvir, paritaprevir, and ritonavir. Ombitasvir is an NS5A inhibitor that inhibits HCV RNA replication and virion assembly. Paritaprevir is an NS3/4A serine protease inhibitor that prevents cleavage of the HCV polyprotein. Ritonavir is a pharmacokinetic enhancer that inhibits CYP3A-mediated metabolism of paritaprevir, increasing its plasma levels.
Treatment of chronic hepatitis C virus (HCV) infection in adults and pediatric patients 3 years and older,Treatment of genotype 1, 2, 3, 4, 5, or 6 HCV infection without cirrhosis or with compensated cirrhosis,Treatment of genotype 1, 2, 3, 4, 5, or 6 HCV infection with decompensated cirrhosis (in combination with ribavirin)
Treatment of chronic hepatitis C virus (HCV) genotype 4 infection in adult patients without cirrhosis or with compensated cirrhosis (Child-Pugh A) in combination with ribavirin
400 mg sofosbuvir / 100 mg velpatasvir orally once daily with or without food for 12 weeks.
TECHNIVIE (ombitasvir, paritaprevir, and ritonavir) is administered orally as two fixed-dose combination tablets (each containing ombitasvir 12.5 mg, paritaprevir 75 mg, and ritonavir 50 mg) taken once daily in the morning with food, in combination with dasabuvir (250 mg twice daily with food) for genotype 1b or with ribavirin for genotype 1a.
Sofosbuvir: 0.4 hr (parent), 27 hr (GS-331007); Velpatasvir: 15 hr. Clinical context: once-daily dosing achieves steady-state in ~1 week.
Terminal half-life approximately 40 hours, supporting once-daily dosing
Sofosbuvir is metabolized in the liver to its active metabolite (GS-461203) via cathepsin A (Cat A) and CES1, followed by phosphorylation. Velpatasvir is metabolized primarily by CYP2B6, CYP2C8, and CYP3A4.
Ombitasvir: Primarily metabolized by amide hydrolysis followed by oxidative metabolism. Paritaprevir: Primarily metabolized by CYP3A4. Ritonavir: Primarily metabolized by CYP3A4 and to a lesser extent by CYP2D6.
Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; Velpatasvir: 94% fecal, 0.4% renal.
Biliary/fecal (majority, >90% as unchanged drug); renal (<1%)
Sofosbuvir: 61-65% (human plasma proteins); Velpatasvir: >99.5% (mainly albumin, alpha-1 acid glycoprotein).
>99.9%, primarily to albumin and alpha-1-acid glycoprotein
Sofosbuvir: ~69 L (calculated as Vd/F); Velpatasvir: ~130 L (calculated as Vd/F). Not typically expressed per kg; indicates extensive tissue distribution.
0.2 L/kg, indicating distribution largely confined to plasma and extracellular fluid
Sofosbuvir: ~92% (oral, with food); Velpatasvir: ~25% (fasted), increased with high-fat meal (up to 2-fold).
Oral: not determined; absorption is rapid with Tmax of 4-5 hours post-dose
No dose adjustment required for GFR ≥30 m L/min. Safety and efficacy not established for GFR <30 m L/min or hemodialysis; use with caution and consider alternative therapy.
No dose adjustment of TECHNIVIE is required for patients with any degree of renal impairment, including those on dialysis. However, if used with ribavirin, refer to ribavirin dosing adjustments for renal impairment.
No dose adjustment for mild or moderate hepatic impairment (Child-Pugh A or B). Not recommended for use in severe hepatic impairment (Child-Pugh C) due to higher exposures of velpatasvir.
TECHNIVIE is contraindicated in patients with moderate to severe hepatic impairment (Child-Pugh class B or C). No dose adjustment is needed for mild hepatic impairment (Child-Pugh class A).
For patients ≥6 years old or weighing ≥17 kg: fixed-dose combination (400 mg/100 mg) once daily with or without food, regardless of weight, for 12 weeks. Safety and efficacy not established for children <6 years or weighing <17 kg.
Safety and efficacy in pediatric patients below 18 years of age have not been established; therefore, no dosing recommendations are available.
No specific dose adjustment required based on age; use same dosing as younger adults, with monitoring for comorbidities and potential drug interactions.
No dose adjustment of TECHNIVIE is required in elderly patients. Clinical studies included patients aged 65 and older, with no overall differences in safety or efficacy observed.
Risk of hepatitis B virus (HBV) reactivation in patients coinfected with HCV and HBV. Test all patients for evidence of current or prior HBV infection before initiating treatment. Monitor for HBV reactivation during and after treatment.
Boxed Warning: Risk of Hepatitis B Virus (HBV) Reactivation. HBV reactivation has been reported in patients co-infected with HCV and HBV who were treated with direct-acting antivirals for HCV. Some cases resulted in fulminant hepatitis, hepatic failure, and death. Test all patients for evidence of current or prior HBV infection before starting Technivie. Monitor patients for HBV reactivation during treatment and post-treatment follow-up.
Risk of HBV reactivation in patients coinfected with HCV and HBV,Increased risk of bradycardia when used with amiodarone, especially in patients on beta-blockers or with cardiac comorbidities,Possible decreased therapeutic effect with strong P-glycoprotein (P-gp) inducers (e.g., rifampin, St. John's wort),Not recommended in patients with severe renal impairment (e GFR <30 m L/min) or end-stage renal disease requiring dialysis
HBV reactivation: Screen for HBV before initiation.,Hepatic decompensation/hepatic failure in patients with cirrhosis: Discontinue if signs of hepatic decompensation occur.,Increases in transaminases: Monitor hepatic function, especially during first 4 weeks of therapy.,Use with estrogen-containing contraceptives: May increase ALT levels; discontinue estrogens if ALT elevation occurs.,Drug interactions: Technivie is a CYP3A4 inhibitor; consider dose adjustments of sensitive CYP3A4 substrates.,Ribavirin: Use with caution in patients with creatinine clearance <50 m L/min.
Concomitant use with amiodarone (risk of symptomatic bradycardia),Concomitant use with strong P-glycoprotein (P-gp) inducers (e.g., rifampin, St. John's wort)
Severe hepatic impairment (Child-Pugh B or C) or decompensated cirrhosis.,Concomitant use with drugs that are strong CYP3A inducers (e.g., rifampin, St. John's wort).,Known hypersensitivity to ombitasvir, paritaprevir, ritonavir, or any excipients.,Concomitant use with drugs highly dependent on CYP3A for clearance (e.g., alfuzosin, ergot derivatives, lovastatin, simvastatin, etc.).,Concomitant use with ethinyl estradiol-containing contraceptives.
Take with or without food. No specific dietary restrictions. Avoid grapefruit juice? No interaction reported. Avoid alcohol as it can worsen liver disease.
Take with food to increase absorption (increase paritaprevir exposure). No specific dietary restrictions. Avoid grapefruit products? Not reported for TECHNIVIE, but ritonavir has interactions with grapefruit; generally not recommended due to potential CYP3A4 interaction.
EPCLUSA (sofosbuvir/velpatasvir) is contraindicated in pregnancy due to the teratogenic risk associated with ribavirin (if used in combination). In the absence of ribavirin, there are no adequate human data; animal studies show no evidence of teratogenicity at clinically relevant exposures. However, due to the potential for ribavirin co-administration in some HCV regimens, pregnancy must be excluded before initiation and avoided during treatment and for 6 months after in females of childbearing potential.
Insufficient human data; animal studies show no teratogenicity at clinically relevant doses. Avoid in pregnancy unless benefit outweighs risk.
No data on the presence of sofosbuvir or velpatasvir in human milk, effects on the breastfed infant, or milk production. Because of the potential for adverse effects in the breastfed infant, breastfeeding is not recommended during treatment and for 6 months after the last dose, especially if ribavirin is co-administered. M/P ratio: unknown.
No data on presence in human milk; risk to infant cannot be excluded. M/P ratio unknown.
No dose adjustment is recommended for EPCLUSA based on pregnancy alone. However, pharmacokinetic changes in pregnancy may alter drug exposure; therapeutic drug monitoring is not currently recommended. Safety and efficacy in pregnant women have not been established.
No dose adjustment required based on pharmacokinetic changes in pregnancy; monitor closely.
EPCLUSA (sofosbuvir/velpatasvir) is a pangenotypic NS5B polymerase inhibitor and NS5A inhibitor combination for chronic HCV. For decompensated cirrhosis (Child-Pugh B/C), co-administer with ribavirin. Monitor for bradycardia when used with amiodarone; avoid co-administration if possible. Check for polymorphisms at baseline if HCV genotype 3 and cirrhosis (consider extending treatment). Assess renal function; not recommended if e GFR <30 m L/min/1.73m² unless on dialysis and benefit outweighs risk.
TECHNIVIE (ombitasvir/paritaprevir/ritonavir) is indicated for chronic hepatitis C genotype 4 without cirrhosis or with compensated cirrhosis (Child-Pugh A). Avoid in decompensated cirrhosis (Child-Pugh B or C) due to risk of hepatic decompensation. Ritonavir is a strong CYP3A4 inhibitor; check for drug interactions. Monitor hepatic function closely, especially in patients with cirrhosis.
Take one tablet (400 mg sofosbuvir/100 mg velpatasvir) orally once daily with or without food.,Complete the full course of treatment (12 weeks for most patients; 24 weeks for genotype 3 with cirrhosis or prior treatment failure).,Use of amiodarone with EPCLUSA can cause serious slowing of heartbeat (bradycardia). Inform your doctor if you take amiodarone.,Avoid taking rifampin, St. John's wort, or certain anticonvulsants (carbamazepine, phenytoin) as they reduce EPCLUSA effectiveness.,Report any symptoms of hepatitis B reactivation (fatigue, jaundice, dark urine) immediately.,If you have diabetes, monitor blood glucose closely as treatment may improve glucose control.,Use effective contraception during treatment and for 6 months after if using combined oral contraceptives containing ethinyl estradiol.
Take with food to improve absorption and reduce gastrointestinal side effects.,Do not stop taking this medication without consulting your doctor.,Inform your doctor of all medications you take, including over-the-counter and herbal supplements, due to significant drug interactions.,Report symptoms of liver problems: yellowing of skin/eyes, dark urine, abdominal pain, or nausea/vomiting.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about EPCLUSA vs TECHNIVIE, answered by our medical review team.
EPCLUSA is a Direct-Acting Antiviral (DAA) for Hepatitis C that works by EPCLUSA is a fixed-dose combination of sofosbuvir, a nucleotide analog NS5B polymerase inhibitor, and velpatasvir, an NS5A inhibitor. Sofosbuvir inhibits HCV RNA replication by acting as a chain terminator, while velpatasvir inhibits HCV replication by binding to NS5A and disrupting viral RNA replication and assembly.. TECHNIVIE is a Direct-acting antiviral that works by Technivie is a fixed-dose combination of ombitasvir, paritaprevir, and ritonavir. Ombitasvir is an NS5A inhibitor that inhibits HCV RNA replication and virion assembly. Paritaprevir is an NS3/4A serine protease inhibitor that prevents cleavage of the HCV polyprotein. Ritonavir is a pharmacokinetic enhancer that inhibits CYP3A-mediated metabolism of paritaprevir, increasing its plasma levels.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between EPCLUSA and TECHNIVIE depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of EPCLUSA is: 400 mg sofosbuvir / 100 mg velpatasvir orally once daily with or without food for 12 weeks.. The standard adult dose of TECHNIVIE is: TECHNIVIE (ombitasvir, paritaprevir, and ritonavir) is administered orally as two fixed-dose combination tablets (each containing ombitasvir 12.5 mg, paritaprevir 75 mg, and ritonavir 50 mg) taken once daily in the morning with food, in combination with dasabuvir (250 mg twice daily with food) for genotype 1b or with ribavirin for genotype 1a.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between EPCLUSA and TECHNIVIE in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. EPCLUSA is classified as Category C. EPCLUSA (sofosbuvir/velpatasvir) is contraindicated in pregnancy due to the teratogenic risk associated with ribavirin (if used in combination). In the absence of ribavirin, there . TECHNIVIE is classified as Category C. Insufficient human data; animal studies show no teratogenicity at clinically relevant doses. Avoid in pregnancy unless benefit outweighs risk.. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.