What Is Epclusa? Uses, Dosage, and What You Need to Know in 2026

Epclusa is a prescription antiviral medication used to treat chronic hepatitis C virus (HCV) infection. It was the first drug ever approved to treat all six genotypes of hepatitis C in a single pill, taken once daily for just 12 weeks. Here's a complete overview of what Epclusa is, how it's used, and what patients can expect.

Quick Facts About Epclusa

• Generic name: Sofosbuvir/velpatasvir
• Brand name: Epclusa
• Manufacturer: Gilead Sciences
• FDA approved: June 28, 2016
• Drug class: Direct-acting antiviral (DAA) — combination NS5B polymerase inhibitor + NS5A inhibitor
• Dosage form: Tablets (400 mg/100 mg) and oral pellets for pediatric patients
• Controlled substance: No
• Average cure rate: ~98% (based on average from 3 clinical studies in adults)

What Is Epclusa Used For?

Epclusa is FDA-approved to treat chronic hepatitis C virus (HCV) infection in adults and children 3 years of age and older. It covers all six genotypes of hepatitis C (genotypes 1 through 6) — which is why it's called "pan-genotypic."

Specifically, Epclusa is approved for patients who:

• Have chronic HCV without cirrhosis (Epclusa alone, 12 weeks)
• Have chronic HCV with compensated cirrhosis (mild liver scarring, Child-Pugh A) — Epclusa alone, 12 weeks
• Have chronic HCV with decompensated cirrhosis (more severe, Child-Pugh B or C) — Epclusa plus ribavirin, 12 weeks
• Have HCV and HIV coinfection — same dosing as HIV-negative patients
• Are liver transplant recipients — Epclusa alone for 12 weeks

What Is the Epclusa Dosage?

For adults:

• One tablet (sofosbuvir 400 mg/velpatasvir 100 mg) once daily
• Can be taken with or without food
• Duration: 12 weeks for most patients

For children 3 years and older, the dose is weight-based. Oral pellets (which can be mixed with food) are available for younger children who cannot swallow tablets. Children under 6 years should take the pellets with food to improve tolerability.

No dose adjustment is needed for kidney impairment (including patients on dialysis) or mild, moderate, or severe liver impairment.

How Effective Is Epclusa?

In clinical trials across four major studies, Epclusa demonstrated exceptional efficacy:

• ~98% average SVR12 (sustained virologic response 12 weeks post-treatment = "cured")
• For patients with compensated cirrhosis: >91% SVR12 across genotypes
• For patients with decompensated cirrhosis (Epclusa + ribavirin): SVR12 of 94%
• For patients on dialysis (ESRD): high SVR12 rates with no dose adjustment needed

"Cured" means the hepatitis C virus is undetectable in your blood 12 weeks after finishing treatment. A successful treatment dramatically reduces your risk of cirrhosis, liver failure, liver cancer, and death from hepatitis C.

Important Things to Know Before Starting Epclusa

• HBV screening required: All patients must be tested for hepatitis B before starting (boxed warning for HBV reactivation).
• Tell your doctor all medications: Epclusa has important interactions with amiodarone, proton pump inhibitors, rifampin, carbamazepine, and others.
• Don't stop early: Stopping Epclusa before completing the full 12 weeks can result in treatment failure and may make future treatment more difficult.
• Reinfection is possible: A successful Epclusa cure doesn't make you immune to hepatitis C. If you're exposed to HCV again (through blood contact or shared needles), reinfection can occur.

Want to learn more? See our detailed guides on how Epclusa works and Epclusa side effects.