Virso 12 Weeks
Virso is comes under the pharmacological category of hepatitis C virus NS5B viral RNA polymerase inhibitor
Virso tablets are prescription medicine, single dose therapy not used ordinarily it is used for the patients who are all having a valid prescription and under the guidance of medical practitioner
In most of the patients, Virso is not combined with peg interferon because of adverse effects produced by peg interferon. Even though this concomitant is avoided, the curable standard of Virso tablet is outstanding rate.
Trade name: Virso
Active ingredient: Sofosbuvir
Package: 28 tablets in a container
Category: Anti-hepaciviral activity
Prescribing information of Virso
The prescribing information of Virso tablets for the patients affected with chronic hepatitis C infection;
Virso is majorly indicated for hepatitis C viral infection therapy by combining with other anti-viral medicines
The effective of Virso is established in the genotype I, II III or IV infections, patients who are having HIV-1/HBV co infection.
Virso mainly prescribed for adolescent patients, and for pediatric patients with age of 12 years or weighing at least 35kg in genotype II or III induced hepatitis C infection
Mechanism of Virso
Virso containing sofosbuvir is a pan genotype, HCV NS5B RNA polymerase inhibitor.
This RNA polymerase enzyme is involved in viral production. Virso is a prodrug which converted into active pharmacological metabolite by undergoing intracellular metabolism.
The active metabolite is known as uridine triphosphate. This metabolite is get inserted into viral RNA by HCV viral RNA polymerase and exhibits anti-viral activity by chain termination process
After an oral administration, the peak plasma time of Virso is reaches within 0.5 to 2 hours and its circulating metabolite GS-331007 has peak plasma time 2 to 4 hours
The human plasma protein bound capacity with Virso is occur nearly at the range of 61 to 65%
The circulating metabolite has minimal protein bounding property.
Virso is highly metabolized in liver, whereas Virso is a substrate of P-gp & BCRP
Virso is eliminated through urine by glomerular filteration
The terminal half life period of Virso is 0.51 hours and its metabolite has 27 hours
How to take the Tablet Virso
Generally Virso is administered with or without food.
Virso tablet is taken as a single dose
Do not crush or chew the tablet, swallow the tablet as whole with some water
400mg of Virso (sofosbuvir)
The recommended dosage of Virso by combination with other medicines;
Patients with genotype III hepatitis:
Virso combined with ribavirin and peg interferon alfa and it should be taken as a single dose for 12 weeks
Otherwise Virso with ribavirin should be taken as single dose for 24 weeks
Patient acquired with genotype I, IV, V or VI chronic hepatitis C viral infection:
Virso is combined with ribavirin and peg interferon alfa should be taken as a single dose for 12 weeks
Virso and ribavirin should be taken in case of patients are undesirable to take peg interferon alfa for 24 weeks
Patients suffered with genotype II chronic hepatitis C:
Virso should be combined with ribavirin as a single dose for 12 weeks
In liver transplantation:
Virso should be concurrently used with ribavirin as a single dose until liver transmission.
Virso tablet is recommended for the children at age 12 or weight of at least 35kg;
In without cirrhosis or with child Pugh A or compensated:
The recommended dosage is one tablet of Virso should be combined with weight based ribavirin as a single dose for 12 weeks
In decompensated cirrhosis:
The prescribed dosage of Virso is one tablet should be used with ribavirin for 24 weeks
Ribavirin is recommended to take in two divided doses only with food
Initial dose 600mg slowly increased up to 100mg per day in weight less than 75kg
1200mg should be taken per day with the weight at least 75kg
In pediatric ribavirin dosage;
47 to 49kg: 600mg/day
50 to 65kg: 800mg/day
66 to 80kg: 1000mg/day
No dosage adjustment is followed in the therapy using Virso in case of renal and hepatic impairment.
Virso caused side effects
General side effects of Virso;
Loss of appetite
Influenza like syndrome
While combining with Virso with amiodarone, no effect of concentration occurs but symptomatic bradycardia occurs
Virso with anti-mycobacterials causes depletion in effect of concentration of Virso
Virso co administration with P-gp or BCRP inhibitors, causes increasing the plasma concentration of Virso
Virso with anticonvulsants like phenytoin, Phenobarbital or carbamazepine causes decreasing the effect of Virso
Virso with analeptic drug like modafinil causes decreasing the effect of concentration of Virso.
Virso is a substrate of P-gp & BCRP transporters. While using Virso with P-gp or BCRP strong inducers like rifampin or st Johns wort may causes decreasing the plasma concentration of sofosbuvir. Thus the results depletion of therapeutic effect of Virso
Virso with vitamin K antagonist, fluctuate the effect of vitamin K antagonist
Food drug interaction
Diet should be followed under the guidance of physician
Drug with herbal interaction occurs like; Virso with st Johns wort may cause depletion of therapeutic effect of Virso
No food drug interaction occurs while taking Virso, but caution should be taken during therapy
Virso tablet combined with ribavirin or peg interferon alfa, contraindicated to pregnancy condition
Hypersensitive reaction produce because of patients contraindicated to the component present in Virso tablet
Use with caution in decompensated condition; ribavirin should be combined with Virso. Ribavirin causes fetal abnormalities and death. In pregnancy condition ribavirin not recommended
In HIV-1/HBV co infected patients, HBV reactivation occurs during or after the treatment, to avoid this problem patient must examine to calculate the level of HBV surface antigen & HBV core antibody before starting the treatment
Virso combined with P-gp or BCRP strong inducers leading to loss of therapeutic effect. Avoid this combination.
While concomitant amiodarone with Virso, patient must counsel about the exposure of this combination, on the other hand some alternative medicines should be prescribed to reduce the risk of symptomatic bradycardia
Pregnancy and lactation
Virso comes under pregnancy category B1
Whereas Virso combined with ribavirin in chronic condition, ribavirin has pregnancy category X; which means causes fetal damage even to death
Ribavirin should not be recommended in pregnancy
Breast feeding should not be recommended
Storage and handling
The storage condition of Virso tablets;
Virso tablet container stored at room temperature below 30oC
Container should be kept in dry and cool place, free from moisture, heat & light
Keep out of reach from children
The shelf life of the tablet is around 5 years
Virso is a prescription medicine, if patient fail to take the dose of Virso must consult with physician and take the dose within the time
Otherwise the missed dose should be skipped and follow the regular dosing schedule
Medicine schedule: prescription medicine
The maximum dose of sofosbuvir is 1200mg, there is no distinct antidote is required for over dose of Virso.
If overdose occurs in the patients two possible way to overcome from this difficulty;
Patients first confirmed from the toxicity and Patients should be periodically monitored for their symptoms & clinical status. To maintain safety measures properly
Hemodialysis is another method which is involved in over dosage condition; predominantly eliminate the sofosbuvir circulating metabolite contents from the body with separating at the range of 54%