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Drug Profile:

Virpas tablets are anti-viral agent.

Virpas tablets which have procured by a patient only with a prescription

Virpas tablets fixed-dose combination contains sofosbuvir and ledipasvir

Trade name: Virpas

Active components: sofosbuvir & ledipasvir

Strength of the components: 400mg & 90mg respectively

Mfg: Strides  

Package: 28 tablets in a container

Category: Anti-cancer agent.

Virpas Prescribing Information:

Virpas is a very effective drug, involves the treatment of chronic hepatitis C viral infection

Virpas is a single dose medicine, used alone or in combination with other anti-viral medicines in a chronic condition.

Virpas, used by the patients having a valid prescription.

Virpas Mechanism of Action:

Virpas has two eminent compounds like;

Sofosbuvir & ledipasvir

Virpas is directly acting anti-viral drug, exhibits its activity by inhibiting the viral replication

Ledipasvir: exhibits its action by intercedes with NS5A activity which is important for viral multiply, secretion, and colony of HCV virions. Due to the effect of ledipasvir, NS5A inhibitor causes eradicate viral growth

Sofosbuvir: Generally it is anti-hepaciviral associated with NS5B polymerase inhibitor. This polymerase enzyme is responsible for viral proliferation, by interfering with these enzymes causes stoppage of viral reproduction acts as a chain terminator.


The absorption of Virpas occurs rapidly, the peak plasma concentration of sofosbuvir 0.8 to 1 hour, ledipasvir is 4 to 4.5 hours; and GS-331007 3.5 to 4 hours.


Virpas should be administered with or without food; the human plasma protein bound of Virpas occurs as >99.8%; sofosbuvir 61 to 65%.

The metabolite of sofosbuvir GS-331007 has minimal plasma protein bounding capability.


Virpas tablet contains ledipasvir which is not metabolized hepatically and is excreted through feces as an unchanged form. Sofosbuvir metabolized to pharmacologically active form GS-461203.


Virpas Excretion occurs through feces and urine


Urine: 80%, feces: 14%, exhaled air: 3.5%


99% in feces & 1% in urine as an unchanged.

When to take the Virpas tablets:

Virpas tablets should be taken as a once a day, with or without a meal

Virpas is a prescription medicine; care should be taken to avoid the self-medication problems

Virpas used either alone or with a combination.

Dosage Regimens

In adults:

The recommended dose of Virpas tablets in adults are;

One tablet 90mg/400mg to be taken as a single dose.

Patients acquired without cirrhosis or with compensated cirrhosis:

Virpas should be taken as a single dose orally for 12 weeks.

Therapy-experienced without cirrhosis:

Virpas should be taken as once a day for 12 weeks.

Therapy-experienced with compensated cirrhosis:

Virpas should be taken as a single dose for 24 weeks alone or in combination with ribavirin.

In decompensated cirrhosis:

Virpas combined with weight-based ribavirin followed for 12 weeks

Ribavirin dosage regimen:

<75kg: 1000mg per day

≥75kg: 1200mg per day.

In Genotype I or IV:

Spontaneous therapy and therapy competent without cirrhosis or with compensated cirrhosis:

Virpas with ribavirin taken for 12 weeks as a single dose.

In genotype IV, V or VI:

Therapy-experienced and therapy naïve without cirrhosis or with compensated cirrhosis:

Virpas should be taken as single dose for 12 weeks.

Dosage adjustment:

In renal and hepatic impairment patients, mild or moderate conditions, on dosage adjustments required

In decompensated condition, safety and efficacy have not been established.

In pediatric:

Used for HCV infection:

Duration of therapy:

Genotype IV, V or VI:

Therapy naïve and experienced without cirrhosis or with compensated cirrhosis:

Virpas followed for 12 weeks as a single dose.

Genotype I:

Therapy naïve with compensated cirrhosis or without cirrhosis:

Virpas recommended for 12 weeks as a single dose.

Therapy-experienced without cirrhosis:

Virpas took orally as a single dose for 12 weeks.

Therapy naïve and experienced without cirrhosis or with compensated cirrhosis:

Virpas took for 24 weeks as a single dose.

Virpas is majorly indicated in pediatric patients with the age of 12 or older or weight of 35kg

<12 years or <35kg: the safety and efficacy has not been established

≥12 years or ≥35kg: one tablet to be taken as single dose.

Virpas Called side effects:

Adverse effects in cirrhosis condition;

Asthenia, headache, fatigue, Myalgia, dyspnea, dizziness and irritability

Elevation of bilirubin levels

Elevation of lipase level

Elevation of creatine kinase levels

In cardiac: bradycardia, cardiac arrest

Skin: angioedema and rashes

Serious bradycardia occurs

While combining with ribavirin, related problems occurs

Common side effects;






Drug Interaction:

Virpas concomitant with other drugs likes;

Virpas With antacids: like proton pump inhibitors, H2 receptor antagonist causes reduce effect of concentration of ledipasvir

Ledipasvir: Drug transporter P-gp inhibitors and breast cancer resistance protein inhibitor, while concomitant with Sofosbuvir and ledipasvir may causes increase the intestinal absorption of these substrates

Virpas with HMG CoA reductase: increase the effect of concentration of these lipid mimic drugs

Virpas With amiodarone: serious bradycardia occurs

Virpas With digoxin: increase the effect of concentration of digoxin

Virpas With anti-convulsants: reduce the effect of concentration of Sofosbuvir and ledipasvir

Virpas With anti-mycobacterials: reduce the effect of concentration of Sofosbuvir and ledipasvir.

Food -Drug Interactions:

Food-drug interaction in Virpas tablets; food does not interfere with the activity of Virpas

Herbal product like st. Johns wort combined with Virpas may causes loss of effect of concentration of Virpas.

Possible Contraindications:

Virpas tablets are contraindicated;

Hypersensitivity reactions occur

Renal and hepatic impairment patients

While combining with ribavirin contraindicated to pregnancy conditions.

Safety Measures:

Exposed to adverse effects due to concomitant with ribavirin.

Risk of the reaction of HBV infection to HCV/HBV co-infected patients.

Care was taken in hepatic and renal impairment patients.

A possibility of symptomatic bradycardia occurs during combination with ribavirin.

Risk of loss of therapeutic effect because of combination with P-gp inducers.

Pregnancy and Lactation:

Virpas with ribavirin pregnancy category: X

Ribavirin causes fetal death

Virpas pregnancy category: B1

Virpas is safe to use in case of monotherapy (used alone)

Breastfeeding is not recommended for the patients who are getting ribavirin.

Storage and Handling:

Virpas tablets container should be stored at room temperature below 30oC.

The container should be kept away from moisture, heat, and light.

Missed Dose:

Virpas tablets are prescription use, before taking the tablet patient must advise by a physician for avoiding self-medication.

If the patient fails to take the dose Virpas, must consult with a medical practitioner and administered the missed dose as soon as possible within the time.

Otherwise, the missed dose should be skipped and maintain the regular dosing schedule.

Do not take an overdose.


The maximum dose of Virpas (Sofosbuvir and ledipasvir) were 1200mg and 120mg twice daily for 10days.

No special antidote is recommended for overdosage of ledipasvir and Sofosbuvir

If overdosage of both drugs, patients should be examined for confirmation of toxicity

Hemodialysis is suitable for elimination of ledipasvir hence; ledipasvir is largely bound to plasma protein and also helps to expel the dominant circulating metabolite of Sofosbuvir GS-331007 with a range of 53%

Other precaution: in case of overdosage, contact poison information center as soon as possible.

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