Comparative Pharmacology
Head-to-head clinical analysis: HARVONI versus HERPLEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HARVONI versus HERPLEX.
HARVONI vs HERPLEX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fixed-dose combination of ledipasvir, an HCV NS5A inhibitor, and sofosbuvir, an HCV NS5B nucleotide polymerase inhibitor. Ledipasvir inhibits HCV NS5A protein essential for viral replication and assembly; sofosbuvir is a prodrug that after intracellular metabolism acts as a chain terminator by inhibiting NS5B RNA-dependent RNA polymerase.
Inhibits viral DNA polymerase after phosphorylation to acyclovir triphosphate, leading to chain termination and inhibition of herpes simplex virus replication.
One tablet (90 mg ledipasvir/400 mg sofosbuvir) orally once daily with or without food for 12 weeks. For treatment-naïve patients with genotype 1 and cirrhosis, 24 weeks may be considered. For genotype 4, 12 weeks recommended.
Acyclovir 200 mg orally 5 times daily for 10 days for initial genital herpes; 400 mg orally twice daily for suppressive therapy; 5-10 mg/kg IV every 8 hours for severe infections.
None Documented
None Documented
Ledipasvir: 47 hours; Sofosbuvir: 0.5 hours; GS-331007 (predominant circulating metabolite): 27 hours; clinical context: supports once-daily dosing with no accumulation beyond steady state by day 7
2.5–3.3 hours in adults with normal renal function; prolonged to 10–20 hours in anuria (CrCl <10 mL/min); requires dose adjustment in renal impairment
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Renal: ~90% as unchanged drug via glomerular filtration and tubular secretion; minor biliary/fecal elimination (<2%)
Category C
Category C
Antiviral
Antiviral