Comparative Pharmacology
Head-to-head clinical analysis: HARVONI versus VEKLURY.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HARVONI versus VEKLURY.
HARVONI vs VEKLURY
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.
Remdesivir is a nucleotide analog prodrug that, after intracellular metabolism, incorporates into nascent viral RNA chains causing synthesis termination and inhibition of RNA-dependent RNA polymerase (RdRp). It targets the SARS-CoV-2 RdRp with selectivity over human RNA polymerases.
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.
200 mg IV on Day 1, then 100 mg IV once daily for 5 to 10 days.
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
Remdesivir: ~1 hour (parent); GS-441524: ~27 hours (terminal). Context: GS-441524 accumulation may occur with daily dosing.
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Renal: 10% unchanged remdesivir; 49% as metabolite GS-441524; 18% as other metabolites. Fecal: 47.5% as metabolites. Biliary: minor.
Category C
Category C
Antiviral
Antiviral