Comprehensive medication guide to Epclusa including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$5 copay with Medicaid; as low as $5/month for commercially insured patients with Gilead's co-pay savings card; typically under $250/month commercial before co-pay card; Medicare Part D covered with $2,100 annual out-of-pocket cap in 2026.
Estimated Cash Pricing
$24,350 retail for brand-name Epclusa per 28-day supply; authorized generic (Asegua Therapeutics) available at approximately $6,728 per 28-day supply. Most patients do not pay the list price due to insurance coverage or patient assistance programs.
Medfinder Findability Score
72/100
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Epclusa (sofosbuvir 400 mg/velpatasvir 100 mg) is a once-daily oral prescription medication used to treat chronic hepatitis C virus (HCV) infection. It was FDA-approved on June 28, 2016 and was the first single-tablet regimen approved for all six hepatitis C genotypes (1 through 6). Epclusa is manufactured by Gilead Sciences, with an authorized generic available through Asegua Therapeutics (a Gilead affiliate).
Epclusa is indicated for adults and children 3 years and older with chronic HCV without cirrhosis or with compensated cirrhosis. Patients with decompensated cirrhosis (Child-Pugh B or C) take Epclusa with ribavirin. The standard treatment duration is 12 weeks for most patients. Epclusa achieves an average cure rate of approximately 98% — meaning HCV becomes undetectable in the blood 12 weeks after completing treatment.
Dosage forms include film-coated tablets (400 mg/100 mg; 200 mg/50 mg) and oral pellets (200 mg/50 mg; 150 mg/37.5 mg) for pediatric patients. The drug can be taken with or without food. No dose adjustment is needed for kidney impairment or any degree of liver impairment.
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Epclusa is a direct-acting antiviral (DAA) that contains two active drugs targeting different proteins the hepatitis C virus needs to replicate. Sofosbuvir is an NS5B RNA-dependent RNA polymerase inhibitor — it blocks the enzyme the virus uses to copy its genetic material. Velpatasvir is an NS5A inhibitor that blocks a viral protein involved in RNA replication and virus particle assembly.
Sofosbuvir works as a prodrug: it is activated inside liver cells into its triphosphate form, where it inserts itself into the viral RNA chain being built by the NS5B polymerase. This terminates the chain and prevents the virus from making complete copies of its RNA. Velpatasvir attacks the NS5A protein from a completely different angle, disrupting both replication and virus assembly. This two-pronged mechanism explains why Epclusa resistance is extremely rare.
Because velpatasvir was specifically engineered to bind effectively to NS5A across all six HCV genotypes, Epclusa is considered pan-genotypic — it works regardless of which strain of hepatitis C a patient has. Over 12 weeks, the virus can no longer replicate and is gradually cleared from the body by the immune system.
400 mg/100 mg — tablet (film-coated)
Standard adult dose: one tablet once daily for 12 weeks
200 mg/50 mg — tablet (film-coated)
Pediatric tablet for weight-based dosing in children ≥3 years
200 mg/50 mg — oral pellets
Pediatric pellets for children unable to swallow tablets; take with food for children under 6
150 mg/37.5 mg — oral pellets
Pediatric pellets for lower weight-based dosing in younger children ≥3 years
Epclusa is not currently listed on the FDA Drug Shortage Database or the ASHP shortage list as of 2026. There is no manufacturing disruption from Gilead Sciences. However, patients commonly face difficulty filling their prescriptions due to logistical and financial barriers rather than a true supply shortage.
The primary barriers include: (1) prior authorization requirements from virtually all insurance plans, which can take days to weeks; (2) specialty pharmacy routing — many plans require Epclusa to be dispensed through a specialty pharmacy rather than retail chains; (3) retail pharmacy reluctance to stock a $24,000+ medication without a confirmed order; and (4) step therapy requirements at some commercial payers that mandate trying Mavyret first.
Once prior authorization is approved, most pharmacies can receive Epclusa within 1-3 business days through their drug wholesaler. Use medfinder to find nearby pharmacies that can fill your Epclusa prescription — medfinder calls pharmacies for you so you don't have to.
Epclusa is not a controlled substance and carries no DEA scheduling requirements. Any licensed prescriber with experience in hepatitis C treatment can prescribe it. However, some state Medicaid programs specifically require prescribers to be specialists (hepatologists, gastroenterologists, or infectious disease physicians) — check your state's Medicaid PA criteria.
Telehealth is available for Epclusa prescribing. Since it is not a controlled substance, there are no federal restrictions on prescribing via telehealth. Several platforms specialize in hepatitis C treatment and can evaluate, prescribe, and manage Epclusa therapy remotely, making this especially valuable for patients in rural areas or with transportation barriers.
No. Epclusa (sofosbuvir/velpatasvir) is not a controlled substance and has no DEA scheduling. It does not have abuse potential and is not subject to the prescribing restrictions that apply to Schedule II-V medications.
As a non-controlled prescription drug, Epclusa can be prescribed by any licensed prescriber — including primary care physicians, nurse practitioners, and physician assistants — in addition to hepatologists, gastroenterologists, and infectious disease specialists. It can also be prescribed via telehealth without the restrictions that apply to controlled substances. Refills are permitted (though the 12-week treatment course typically requires one or two dispenses rather than ongoing refills).
Epclusa is well-tolerated by most patients. The most common side effects occurring in ≥10% of adults and children 6 years and older are:
In children under 6 years taking oral pellets: vomiting and spitting up the medication. Additional side effects occur when Epclusa is combined with ribavirin for decompensated cirrhosis: fatigue (32%), anemia (26%), nausea (15%), headache (11%), insomnia (11%), diarrhea (10%).
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Mavyret (glecaprevir/pibrentasvir)
Pan-genotypic DAA by AbbVie; 8-week treatment for most treatment-naïve patients; not for decompensated cirrhosis; often preferred by payers due to lower cost
Harvoni (ledipasvir/sofosbuvir)
Gilead DAA for genotypes 1, 4, 5, and 6 only (not all genotypes); 8-24 weeks depending on status; generic available
Vosevi (sofosbuvir/velpatasvir/voxilaprevir)
Triple-drug DAA by Gilead; for patients who previously failed a DAA regimen; 12-week treatment
Zepatier (elbasvir/grazoprevir)
Merck DAA for genotypes 1 and 4; useful in patients with kidney disease; less commonly used due to narrower genotypic coverage
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Amiodarone (Cordarone, Pacerone)
majorCoadministration can cause serious symptomatic bradycardia, including cases requiring pacemaker insertion or resulting in death. Contraindicated.
Proton Pump Inhibitors (omeprazole, esomeprazole, etc.)
majorPPIs raise stomach pH, significantly reducing velpatasvir absorption and Epclusa efficacy. Coadministration is not recommended.
Rifampin
majorStrong P-gp and CYP inducer that dramatically reduces sofosbuvir and velpatasvir levels, making Epclusa ineffective. Avoid.
Carbamazepine (Tegretol)
majorCYP3A4 inducer that decreases velpatasvir plasma concentrations. Avoid.
St. John's Wort
majorHerbal P-gp/CYP inducer that reduces sofosbuvir and velpatasvir levels. Avoid entirely during treatment.
Efavirenz (Sustiva, Atripla)
majorStrong CYP inducer that substantially reduces velpatasvir levels. Avoid in HCV/HIV coinfected patients if possible.
Tenofovir DF (Viread)
moderateVelpatasvir may increase TDF exposure. Monitor for tenofovir-associated renal and bone toxicity.
Rosuvastatin and other OATP substrates
moderateVelpatasvir inhibits OATP1B1/1B3 transporters, potentially increasing statin exposure. Monitor for statin-related side effects.
Antacids (calcium carbonate, etc.)
minorSeparate antacid administration from Epclusa by at least 4 hours to avoid reducing velpatasvir absorption.
H2 receptor antagonists (famotidine)
minorCan be taken simultaneously with or 12 hours apart from Epclusa; dose should not exceed famotidine 40 mg twice daily.
Epclusa represents one of the most significant advances in the history of hepatitis C treatment. Its pan-genotypic coverage, 12-week duration, once-daily dosing, and ~98% cure rate make it a landmark therapy. For most patients, the biggest challenge is not the treatment itself — it's the access and cost barriers that stand between diagnosis and starting the first pill.
With robust patient assistance programs through Gilead's Support Path, broad Medicaid coverage, Medicare Part D coverage with a 2026 out-of-pocket cap of $2,100, and an authorized generic at a fraction of the brand price, most patients can access Epclusa at a manageable cost. The key is knowing which programs to use and navigating the prior authorization process effectively.
If you have a prescription for Epclusa and are struggling to find a pharmacy that can fill it, medfinder can help. You provide your medication, dosage, and location — medfinder contacts nearby pharmacies and texts you results. Don't let pharmacy logistics delay your hepatitis C cure.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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