Hepatitis B Reactivation:
If you have a history of hepatitis B, taking Epclusa can cause the virus to reactivate. Your doctor will test you for hepatitis B before starting treatment and monitor you during and after therapy.
Drug Interactions:
Avoid combining Epclusa with the following medications, as they can reduce its effectiveness or increase side effects:
Rifampin, carbamazepine, phenobarbital, and phenytoin (reduce drug levels).
Amiodarone (risk of severe bradycardia).
St. John’s Wort (reduces drug levels).
Do not take antacids or proton pump inhibitors (e.g., omeprazole) within 4 hours of Epclusa, as they interfere with absorption.
Liver Complications:
If you have decompensated cirrhosis (Child-Pugh B or C), your doctor may combine Epclusa with ribavirin. Ribavirin use carries additional risks, such as anemia, which must be monitored closely.
Pregnancy and Breastfeeding:
Avoid Epclusa with ribavirin during pregnancy, as ribavirin can cause severe birth defects. Women of childbearing age should use effective contraception during treatment and for 6 months after stopping ribavirin.
There is limited data on the use of Epclusa during breastfeeding, so consult your doctor.
Kidney Function:
If you have severe kidney disease or are on dialysis, Epclusa should be used cautiously, as its effects in these conditions are not well-studied.
Allergic Reactions:
Discontinue use immediately and seek medical attention if you experience symptoms such as rash, swelling, or difficulty breathing.
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