Comparative Pharmacology
Head-to-head clinical analysis: HARVONI versus SYMMETREL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HARVONI versus SYMMETREL.
HARVONI vs SYMMETREL
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 influenza A virus uncoating and viral RNA replication; increases dopamine release and blocks dopamine reuptake in the CNS.
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.
100 mg orally twice daily; may increase to 200 mg orally twice daily if tolerated, usually in divided doses. For Parkinson's disease, 100 mg orally twice daily; for drug-induced extrapyramidal reactions, 100 mg orally twice daily.
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
Terminal half-life: 24-48 hours (young adults); 48-72 hours (elderly); may extend to 7-10 days in severe renal impairment. Clinically, steady-state achieved in 4-7 days.
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Primarily renal excretion (90-95% unchanged) via glomerular filtration and tubular secretion; minor fecal (<5%). Dose adjustment required in renal impairment.
Category C
Category C
Antiviral
Antiviral and Antiparkinsonian