{"id":52291,"date":"2023-09-20T09:31:27","date_gmt":"2023-09-20T09:31:27","guid":{"rendered":"https:\/\/medsname.com\/velpanat\/"},"modified":"2026-05-01T05:31:53","modified_gmt":"2026-05-01T05:31:53","slug":"velpanat","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/velpanat\/","title":{"rendered":"Velpanat"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Velpanat<\/strong> \u2014 combina\u021bie fix\u0103 de sofosbuvir 400 mg + velpatasvir 100 mg (Natco Pharma). Regim pan-genotipic cu o singur\u0103 tablet\u0103 pentru hepatita cronic\u0103 C la toate cele 6 genotipuri \u2014 12 s\u0103pt\u0103m\u00e2ni o dat\u0103 pe zi. Rata de vindecare \u226595%, inclusiv pentru genotipul 3 \u0219i ciroza decompensat\u0103 (cu ribavirin\u0103). Generic al Gilead Epclusa.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Ce beneficii ofer\u0103 MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>produc\u0103tor certificat WHO-GMP<\/li>\n<li>Ambalaj discret \u00een plic simplu<\/li>\n<li>Livrare \u00een toat\u0103 lumea<\/li>\n<li>Evaluat de peste 1.400 de clien\u021bi (<a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">cite\u0219te recenziile<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Garan\u021bia de retransmitere:<\/strong> dac\u0103 comanda dvs. nu a ajuns \u00een 20 de zile lucr\u0103toare de la expediere, o retransmitem f\u0103r\u0103 costuri suplimentare. <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Cite\u0219te politica<\/a>.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Velpanat este expediat de la un produc\u0103tor certificat WHO-GMP \u00een ambalaje simple, facturat prin intermediul unui procesor de pl\u0103\u021bi reglementat (descrierea extrasului de cont indic\u0103 un procesor de pl\u0103\u021bi cu carduri reglementat \u2014 niciodat\u0103 MedsBase sau numele vreunui medicament). Fiecare comand\u0103 beneficiaz\u0103 de Asigurarea noastr\u0103 de Reexpediere \u00een 20 de zile lucr\u0103toare.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Avertizare FDA: reactivare HBV<\/strong><br \/>Toate terapiile DAA pentru hepatita C poart\u0103 o avertizare FDA privind reactivarea virusului hepatitei B la pacien\u021bii cu infec\u021bie mixt\u0103 HCV + HBV (care poate fi fulminant\u0103 \u0219i fatal\u0103). Testa\u021bi HBsAg \u0219i ADN HBV \u00eenainte de a \u00eencepe orice regim DAA. Dac\u0103 HBV-pozitiv, hepatologul trebuie s\u0103 gestioneze cotratamentul sau terapia profilactic\u0103 anti-HBV.<\/div>\n<h2>Cum func\u021bioneaz\u0103<\/h2>\n<p>Dou\u0103 DAA-uri pan-genotipice \u00eentr-o singur\u0103 tablet\u0103:<\/p>\n<ul>\n<li><strong>Sofosbuvir<\/strong> \u2014 inhibitor al polimerazei nucleotidice NS5B (terminator de lan\u021b)<\/li>\n<li><strong>Velpatasvir<\/strong> \u2014 inhibitor NS5A de genera\u021bia a doua, cu acoperire mai larg\u0103 \u0219i barier\u0103 mai \u00eenalt\u0103 la rezisten\u021b\u0103 dec\u00e2t ledipasvir<\/li>\n<\/ul>\n<p>Velpatasvir are activitate asupra tuturor celor 6 genotipuri de VHC, inclusiv G2 \u0219i G3, unde regimurile bazate pe ledipasvir sunt mai slabe. Combina\u021bia este regimul preferat de OMS pentru set\u0103rile cu resurse limitate (nu este necesar\u0103 testarea genotipului \u00eenainte de tratament).<\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Se administreaz\u0103 cu sau f\u0103r\u0103 alimente<\/strong><br \/>Absorb\u021bia velpatasvirului este dependent\u0103 de pH. Evita\u021bi inhibitorii de pomp\u0103 de protoni dac\u0103 este posibil; dac\u0103 sunt necesari, lua\u021bi comprimatul DAA diminea\u021ba, cu alimente, apoi lua\u021bi IPP mai t\u00e2rziu. Antiacidele cu \u22654 ore de separare.<\/div>\n<h2>Tabel cu durata tratamentului<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Popula\u021bie<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">Regim<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Toate genotipurile (1-6), naive la tratament, f\u0103r\u0103 ciroz\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni un comprimat zilnic \u2014 pan-genotipic<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Toate genotipurile cu ciroz\u0103 compensat\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni un comprimat zilnic<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Pacien\u021bi cu experien\u021b\u0103 de tratament (orice genotip, f\u0103r\u0103 ciroz\u0103)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni un comprimat zilnic<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Ciroz\u0103 decompensat\u0103 (Child-Pugh B\/C)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni + ribavirin\u0103 (supraveghere specializat\u0103 hepatologic\u0103)<\/td>\n<\/tr>\n<\/table>\n<p>R\u0103spunsul virologic sus\u021binut la 12 s\u0103pt\u0103m\u00e2ni post-tratament (SVR12) este markerul vindec\u0103rii \u2014 ob\u021binut \u00een ~95-99% din pacien\u021bi cu regimuri moderne de DAA.<\/p>\n<h2>Interac\u021biuni medicamentoase importante<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Medicament<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">Efect \u0219i ac\u021biune<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Amiodaron\u0103 + sofosbuvir<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\"><strong>Avertizare FDA \u2014 bradicardie simptomatic\u0103, cazuri de deces raportate.<\/strong> Evita\u021bi combina\u021bia. Dac\u0103 este inevitabil\u0103, este necesar monitorizarea cardiac\u0103 \u00een spital.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">PPI (omeprazol, pantoprazol)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Reduce absorb\u021bia ledipasvirului (dependent\u0103 de pH). Administra\u021bi regimurile care con\u021bin ledipasvir cu alimente \u0219i PPI la interval de \u22654 ore, sau folosi\u021bi antagoni\u0219ti H2\/antiacide \u00een loc. Velpatasvir este de asemenea sensibil la pH \u2014 aceea\u0219i recomandare.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Rifampicin\u0103, rifabutin\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Inductori puternici ai CYP3A4 + P-gp \u2014 reduc semnificativ nivelurile de DAA. Evita\u021bi combina\u021bia.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Iarba Sf\u00e2ntului Ioan<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Induc\u021bia CYP3A4 \u2014 reduce nivelurile de DAA \u0219i riscul de e\u0219ec terapeutic. Evita\u021bi pe tot parcursul terapiei.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Fenitoin\u0103, carbamazepin\u0103, oxcarbazepin\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Inductori anticonvulsivanti \u2014 reduc semnificativ nivelurile DAA. Trecerea la un antiepileptic neinduc\u0103tor (lamotrigin\u0103, levetiracetam) \u00eenainte de \u00eenceperea terapiei hepatitei C.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Statine (rosuvastatin\u0103, atorvastatin\u0103)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Cre\u0219teri variabile ale nivelurilor de statin\u0103. Utiliza\u021bi doza cea mai mic\u0103; rosuvastatina este \u00een general evitat\u0103 cu sof+vel; atorvastatina este acceptabil\u0103 la doze mici.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Warfarin<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">INR poate fluctua pe m\u0103sur\u0103 ce ficatul se recupereaz\u0103 \u00een timpul terapiei DAA. Monitoriza\u021bi INR s\u0103pt\u0103m\u00e2nal p\u00e2n\u0103 la stabilizare.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Antiretrovirale HIV<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Tenofovir + ledipasvir \u2014 expunere crescut\u0103 la tenofovir; monitoriza\u021bi func\u021bia renal\u0103. Efavirenz reduce nivelurile de velpatasvir \u2014 evita\u021bi combina\u021bia. Coinfec\u021bia HCV-HIV necesit\u0103 \u00eentotdeauna consult specializat ID\/hepatologie.<\/td>\n<\/tr>\n<\/table>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>Care este rata de vindecare?<\/h3>\n<p>Regimurile moderne DAA ob\u021bin r\u0103spuns virologic sus\u021binut (SVR12) \u2014 ARN HCV nedetectabil la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament, considerat vindecare \u2014 la 95-99% din pacien\u021bi pe toate genotipurile. Ciroza, e\u0219ecul tratamentelor anterioare \u0219i coinfec\u021bia HCV\/HIV reduc u\u0219or ratele de r\u0103spuns.<\/p>\n<h3>Ce este SVR12?<\/h3>\n<p>R\u0103spuns Virologic Sus\u021binut la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament. Dup\u0103 finalizarea unui curs DAA de 12 s\u0103pt\u0103m\u00e2ni, ARN HCV este verificat la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 ultima doz\u0103. Nedetectabil = vindecare. Recidiva t\u00e2rzie dup\u0103 SVR12 este &lt;1%.<\/p>\n<h3>Voi avea nevoie de un test de urm\u0103rire?<\/h3>\n<p>Da. ARN HCV la sf\u00e2r\u0219itul tratamentului + la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament confirm\u0103 SVR12. Biochimia hepatic\u0103 \u0219i FibroScan\/imagistic\u0103 la 6-12 luni la pacien\u021bii cirotici pentru evaluarea regresiunii. Chiar \u0219i dup\u0103 vindecare, screening pentru carcinom hepatocelular la fiecare 6 luni dac\u0103 ciroza este stabilit\u0103.<\/p>\n<h3>Ce spune\u021bi despre hepatita B?<\/h3>\n<p>Toate DAA-urile poart\u0103 un avertisment FDA pentru reactivarea HBV la pacien\u021bii cu coinfec\u021bie HCV+HBV. Testa\u021bi HBsAg \u0219i ADN HBV \u00eenainte de \u00eencepere. Dac\u0103 HBV-pozitiv, hepatologia trebuie s\u0103 coordoneze.<\/p>\n<h3>Pot consuma alcool?<\/h3>\n<p>Evita\u021bi consumul de alcool pe tot parcursul tratamentului \u0219i, ideal, pentru 6-12 luni dup\u0103. Consumul activ de alcool nu exclude terapia cu DAA, dar \u00eenr\u0103ut\u0103\u021be\u0219te rezultatele pe termen lung ale ficatului, indiferent de starea de HCV.<\/p>\n<h3>Sarcin\u0103?<\/h3>\n<p>Sofosbuvir este clasificat de FDA \u00een categoria B de sarcin\u0103 (nu exist\u0103 date despre teratogenitate uman\u0103; datele animale sunt lini\u0219titoare). Majoritatea DAA-urilor nu au date despre sarcin\u0103. Contraceptia \u00een timpul terapiei este standard. Ribavirina (c\u00e2nd este utilizat\u0103 ca adjunct) este puternic teratogen\u0103 \u2014 ambii parteneri trebuie s\u0103 foloseasc\u0103 contraceptie \u00een timpul terapiei cu ribavirin\u0103 \u0219i 6 luni dup\u0103.<\/p>\n<h3>Efecte secundare?<\/h3>\n<p>DAA-urile moderne sunt \u00een general bine tolerate. Frecvente: oboseal\u0103, cefalee, grea\u021b\u0103, insomnie. Mai pu\u021bin frecvente: erup\u021bii cutanate, diaree. Efectele secundare care limiteaz\u0103 tratamentul sunt rare.<\/p>\n<h3>Generice vs originale \u2014 conteaz\u0103?<\/h3>\n<p>DAA-urile generice indiene sunt fabricate sub licen\u021be voluntare de la Gilead (Sovaldi, Harvoni, Epclusa), AbbVie \u0219i BMS. Sunt bioechivalente \u0219i con\u021bin aceea\u0219i molecul\u0103. Multiple studii din practic\u0103 (CT2, Plus-Asia) arat\u0103 rate SVR12 echivalente cu produsele originale.<\/p>\n<h3>Interac\u021biuni medicamentoase de urm\u0103rit?<\/h3>\n<p>Cele mai importante: amiodaron\u0103 + sofosbuvir (bradicardie cu avertizare \u00een cutie neagr\u0103), rifampicin\u0103 (scade nivelurile de DAA), PPI (reduc ledipasvir\/velpatasvir), ajust\u0103ri necesare pentru ARV HIV \u00een caz de co-infec\u021bie. Dezv\u0103lui\u021bi \u00eentotdeauna toate medicamentele, inclusiv cele pe baz\u0103 de plante\/OTC.<\/p>\n<h3>Dup\u0103 vindecare \u2014 pot s\u0103 fac din nou HCV?<\/h3>\n<p>Da. SVR elimin\u0103 infec\u021bia curent\u0103, dar nu ofer\u0103 imunitate viitoare. Re-infec\u021bia prin noi expuneri (consum de droguri intravenos, proceduri medicale nesigure, MSM cu co-infec\u021bie HIV) este posibil\u0103. Consilierea privind preven\u021bia \u0219i oferirea test\u0103rii HCV RNA la orice nou\u0103 expunere la risc.<\/p>\n<p class=\"medsbase-link-boost-2026-04-30\" data-marker=\"mb-link-boost-hepcinat-lp\">Pentru genotipul 1, 4, 5 sau 6 al VHC \u00een mod specific, <a href='\/ro\/hepcinat-lp\/'>Hepcinat LP (sofosbuvir + ledipasvir)<\/a> este o alternativ\u0103 eficient\u0103 la Velpanat pan-genotipic \u2014 de obicei pu\u021bin mai ieftin \u0219i sus\u021binut de date extinse din practica real\u0103.<\/p>\n<p data-mb-link-target=\"hepcinat-lp\" data-mb-anchor-variant=\"v2\" style=\"margin-top:1em;font-size:0.95em;color:#444;border-left:3px solid #2c7cb0;padding:0.5em 0.75em;background:#f4f8fb;\"><strong>Vezi \u0219i:<\/strong> <a href=\"https:\/\/medsbase.com\/ro\/hepcinat-lp\/\"><strong>combina\u021bia sofosbuvir-ledipasvir (Hepcinat LP)<\/strong><\/a> \u2014 Harvoni generic de la Natco \u2014 sofosbuvir 400 mg + ledipasvir 90 mg \u00eentr-un singur curs de 12 s\u0103pt\u0103m\u00e2ni pentru hepatita C genotipuri 1, 4, 5, 6.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Alte medicamente pentru hepatita C<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/ledifos\/\">Ledifos<\/a> \u2014 sofosbuvir + ledipasvir \u2014 alternativ\u0103 pentru genotipurile 1\/4\/5\/6<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hepcvir-l\/\">Hepcvir L<\/a> \u2014 sofosbuvir + ledipasvir \u2014 marc\u0103 Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/natdac\/\">Natdac<\/a> \u2014 daclatasvir pentru regimuri \u00een asociere cu sofosbuvir<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/myhep\/\">MyHep<\/a> \u2014 terapie de baz\u0103 cu sofosbuvir 400 mg \u00een monoterapie<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hepcinat\/\">Hepcinat<\/a> \u2014 sofosbuvir 400 mg \u2014 marc\u0103 Natco<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Disclaimer medical:<\/strong> Aceast\u0103 pagin\u0103 este doar informativ\u0103 \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui clinician calificat. Discuta\u021bi orice medicament nou cu medicul sau farmacistul dumneavoastr\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Velpanat (Sofosbuvir + Velpatasvir 400 + 100 mg) \u2014 generic Natco al Epclusa. Tablet\u0103 pan-genotipic\u0103 pentru vindecarea hepatitei C, 12 s\u0103pt\u0103m\u00e2ni o dat\u0103 pe zi pentru genotipurile 1-6.<\/p>","protected":false},"featured_media":52292,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3334],"product_tag":[],"class_list":{"0":"post-52291","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hepatitis-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/52291","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=52291"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/52292"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=52291"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=52291"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=52291"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=52291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}