Comparative Pharmacology
Head-to-head clinical analysis: HARVONI versus LETERMOVIR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HARVONI versus LETERMOVIR.
HARVONI vs LETERMOVIR
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.
Letermovir is an antiviral agent that inhibits the human cytomegalovirus (CMV) terminase complex, specifically the pUL56 subunit, thereby preventing viral DNA processing and packaging.
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.
480 mg orally once daily (two 240 mg tablets).
None Documented
None Documented
Clinical Note
moderateLetermovir + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Letermovir."
Clinical Note
moderateLetermovir + Haloperidol
"The metabolism of Haloperidol can be decreased when combined with Letermovir."
Clinical Note
moderateLetermovir + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Letermovir."
Clinical Note
moderateLetermovir + Dronedarone
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
The terminal elimination half-life is approximately 12 hours (range 10–18 hours) in healthy subjects, allowing once-daily dosing.
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Letermovir is primarily eliminated via biliary/fecal excretion (approximately 93% of the dose recovered in feces, with <2% as unchanged drug) and renal excretion accounts for <7% (mostly as metabolites, <1% unchanged).
Category C
Category C
Antiviral
Antiviral
"The metabolism of Dronedarone can be decreased when combined with Letermovir."