Ledipasvir: a practical guide for people treating hepatitis C

If you or someone you care for has hepatitis C, you may see ledipasvir mentioned a lot. It’s the antiviral drug used in combination with sofosbuvir (brand name Harvoni) to clear many types of hepatitis C. This guide explains what ledipasvir does, how treatment usually works, and the key safety points to watch for.

How ledipasvir works and who it helps

Ledipasvir blocks a viral protein (NS5A) the hepatitis C virus needs to copy itself. By pairing ledipasvir with sofosbuvir you attack the virus on two fronts, which helps reach high cure rates—often over 90% for genotype 1 and several other genotypes. Doctors decide treatment length (commonly 8 to 12 weeks, sometimes 24) based on your virus type, past treatment history, and whether you have liver cirrhosis.

Before starting therapy you’ll typically get an HCV RNA test (viral load), genotype testing, and blood work to check liver and kidney function. Those results shape the exact plan.

Safety, side effects, and drug interactions

Common side effects are usually mild: fatigue, headache, and nausea. Serious problems are rare, but you should report new symptoms like fainting, severe weakness, chest pain, or very dark urine. If you have advanced liver disease or a low eGFR, your doctor will pick the safest option—some regimens aren’t suitable for severe kidney impairment.

Drug interactions matter. Avoid strong P-glycoprotein inducers (for example, rifampin or St. John’s wort) because they can lower sofosbuvir and ledipasvir levels and reduce effectiveness. Antacids can lower ledipasvir absorption—space antacid use by several hours and talk to your doctor before taking proton pump inhibitors; small doses of omeprazole may be allowed with food under medical advice. Also, combining sofosbuvir with amiodarone can cause slow heart rate; your clinician will check if this matters for you.

If you’re pregnant or planning pregnancy, discuss it with your provider—some hepatitis C regimens and companion drugs require special precautions. Breastfeeding and fertility questions are worth a direct talk with your healthcare team too.

Practical tips: take the tablet once daily at the same time, stick with the full course even if you feel better, and keep follow-up HCV RNA testing (often at week 4 and 12 weeks after finishing) to confirm cure (SVR12). Don’t stop or change doses without asking your provider.

Finally, get medications through licensed pharmacies with a prescription. Cheap, unverified online sellers can sell fake or unsafe products that put your cure at risk. If you have questions about ledipasvir-specific instructions, your pharmacist or prescriber should give clear, personalized advice.