Indian drugs for the treatment of hepatitis C

Operating principle of DPP

Modern drugs for viral hepatitis C differ in their principle of action from generally accepted interferon regimens. Unlike Interferon, DAAs act directly on the virus. The main components of the drugs suppress the activity of ribonucleic acid and block the reproduction processes of the pathogen. Gradually, the virus weakens and leaves the host’s body. A relapse is unlikely.

Indian medicine for hepatitis C is based on official and patented formulas developed in the USA. One of the founding companies of a new method of treating HCV is the American company Gilead. But the cost of American drugs is extremely high not only for Russian citizens, but also for patients from the USA and Europe. Prices for Indian generics for hepatitis C are much lower, and the principle of action and effectiveness are completely equivalent to American medicines.

How do generics differ from drugs from the USA?

Before talking about the differences, let's explain what a generic . The company developing medicinal formulas receives a patent for the invented drug. During the period specified in the document, the developer has the exclusive right to produce this medicine.

The deadline for such a patent is 20 years. After this period, other companies have the opportunity to produce drugs with identical composition. The developer provides a license to produce medicines according to his formula.

Generics are drugs created on the basis of drugs previously developed and patented by other companies. High-quality medicines are not inferior in effectiveness to original medicines.

The main difference between Indian generics for the treatment of hepatitis C is their affordable cost. In terms of composition, inconsistencies can only be observed in the list of auxiliary components. The content of active substances is completely similar to the original one.

Requirements for drug production in India

You should not assume that any pharmaceutical company that wishes can obtain an International license to produce drugs for the treatment of hepatitis C. The activities and capabilities of the manufacturer must comply with the requirements of the International Commission for the Production of Medicines.

In particular, the required standards are:

• Qualitative and quantitative ratio of drug components corresponding to the recipe.
• Compliance of technical equipment with global standards.
• Availability of laboratories for research and testing of manufactured drugs for the treatment of hepatitis C.

For a long time, production in most countries did not meet the standards listed above. Drugs for the treatment of viral hepatitis C were available only to residents of the United States, Canada and Europe and cost thousands of American dollars.

Currently, 11 pharmaceutical companies in India meet the drug manufacturing requirements. This helps lower therapy prices because manufacturers do not have to pay for testing and developing components . The low price of treating hepatitis C with generics from India is due to the fact that companies only pay for the annual renewal of the license.

Indian drugs: what are the advantages?

Gilead Sciences company that has received a patent on Sofosbuvir, a hepatitis C drug designated as essential by WHO. The cost of a course of treatment with this medicine is tens of thousands of dollars. The fixed cost of 1 package of the drug against hepatitis C Sovaldi based on Sofosbuvir is 126,000 rubles. For a long time, only such expensive medications were available to patients.

The situation changed when pharmaceutical manufacturers in India were granted licenses to create Sofosbuvir at their production facilities using Gilead Sciences technology. Thus, Indian drugs for hepatitis C produced by Zydus Heptiza, Mylan, Natco, Hetero, Dr. Reddy's, Aprazer .

They are manufactured under official license from Gilead Sciences and have been approved by the FDA. This is a guarantee of safety and quality. It is these parameters that distinguish Indian generics from dubious Chinese and Egyptian drugs , which are often produced without a license.

Treatment of hepatitis C with Indian drugs has received worthy reviews from doctors in all clinics around the world. Minimal side effects and proven effectiveness are a significant advantage. Licensed medicines from India really quickly cope with the disease: they block the spread of the virus in the blood and have a pronounced antiviral effect.

Features of therapy

Treatment for hepatitis C involves removing the virus from the body. It is considered successful when the pathogen in the blood cannot be detected using a PCR test for hepatitis C for 5 years after the end of therapy.

If the patient has a sustained virological response, then he can be considered completely cured. In this case, the degree of fibrosis is reduced, the likelihood of developing a malignant liver tumor is reduced, life expectancy is extended and its quality is improved.

For the treatment of viral hepatitis, antiviral drugs, hepatoprotectors, and immunomodulators are prescribed.

The treatment regimen should be selected only by a doctor, depending on a number of factors:

• genotype of the virus and viral load (the number of pathogens in the blood);
• age and gender of the infected patient;
• duration of infection;
• liver conditions (presence of compensated and decompensated cirrhosis);
• the presence of a hereditary predisposition to the development of cirrhosis and cancer;
• presence of HIV co-infection;
• unsuccessful previous therapy for hepatitis C.

Before prescribing certain medications, the doctor prescribes a series of tests and the following examinations:

• blood to determine the pathogen genotype and viral load;
• blood for hepatitis B, in order to get vaccinated, if according to the results of the analysis, vaccination is acceptable;
• biochemical analysis to assess liver function;
• Doppler ultrasound of the abdominal organs;
• fibroscanning, Fibro Test, Fibro Max, which can be used to assess the degree of fibrosis;
• general blood test, blood for autoantibodies, thyroid hormones, ultrasound (these studies are prescribed to identify contraindications to starting therapy);
• for persons over 40 years of age, the condition of the cardiovascular and respiratory systems is additionally examined.

Only after this, depending on the test results, the doctor selects medications for hepatitis C.

Popular Indian medicines for hepatitis C

Treatment of hepatitis C with Indian drugs is available in most countries of the world. Medicines can be purchased completely legally on the territory of the Russian Federation and a number of other states.

Let's look at the main medications: their advantages, disadvantages and features of use. In our country, patients diagnosed with hepatitis C can purchase the following Indian-made medicines:

• Sofosbuvir
• Daclatasvir
• Velpatasvir
• Ledipasvir

These are the most effective hepatitis C medicines from India.

Sofosbuvir

The drug Sofosbuvir has no significant side effects. Actively fights hepatitis of any genotype. Recently, it can be used by children from 12 years of age. The admissibility of such therapeutic methods has been proven by clinical studies.

The active substance inhibits RNA activity and prevents the formation of viable virions. The weakened virus loses its ability to replicate unhindered, dies and is completely eliminated from the body.

It is recommended to use Sofosbuvir together with Daclatasvir . The drugs are available in tablet form. Therapy cannot be interrupted; the course of treatment is from 3 months to six months. The drug is not used as a monotherapy.

The most commonly purchased Indian generics for hepatitis C include the following medications based on Sofosbuvir:

• SoviHep - produced by Zydus Heptiza/
• Hepcinat - Sofosbuvir from the world famous pharmaceutical giant Natco Pharma.
• Sofovir is a drug for the treatment of hepatitis C from Hetero.
• Sofokast from Aprazer - produced at Natco factories.
• MyHep is a cure for Mylan.

The drugs are identical in composition, are not addictive and are easily absorbed by the human body.

Daclatasvir

The medicine for hepatitis C from India, Daclatasvir, cannot be taken alone as monotherapy. The most effective treatment will be achieved only in combination with Sofosbuvir - from 95%. Complexes of these drugs are available for sale on the Russian medical market, which allows you to save money when purchasing.

The active substance in question, like all subsequent ones, is an inhibitor of the NS5A protein of the virus. The component blocks the entry of the pathogen into the patient’s bloodstream. If you need to buy Indian drugs for hepatitis C based on Daclatasvir, you can choose between:

• Dacihep by Zydus Heptiza.
• Natdac from Natco Pharma.
• MyDekla from Mylan.
• Dacikast by Aprazer.
• Daclahep by Hetero.

All the drugs listed above are equivalent in composition and effectiveness. The price varies slightly depending on the manufacturer.

Side effects from taking hepatitis C tablets from India are rare. These include:

• Headache.
• Digestive problems.
• The appearance of nervousness and anxiety.

Treatment of hepatitis with Indian generics should be prescribed by a doctor in the absence of contraindications.

Velpatasvir

The drug is used to combat hepatitis of any genotype. The effectiveness of Velpatasvir is 100% for genotypes 1, 2, 4 and 98% for genotype 3. Treatment of hepatitis C with the Sofosbuvir + Velpatasvir complex is recommended for patients with liver cirrhosis. Contraindications for use:

• Children under 18 years of age.
• Women during pregnancy.

Should be used with caution in patients with renal failure. The doctor should prescribe doses and duration of treatment.

The most popular Indian generics based on Velpatasvir include the following drugs for the treatment of HCV:

• SoviHep V by Zydus Heptiza.
• MyHep All by Mylan.
• Velpanat from Natco Pharma.
• Velakast from Aprazer.
• Velasof from Hetero.

The drugs listed above contain a therapeutic dose of Sofosbuvir and Velpatasvir, sufficient for the full treatment of hepatitis C.

Ledipasvir

This medicine for hepatitis C from India should be used for hepatitis genotypes 1, 4, 5 and 6. There are a number of restrictions for taking Ledipasvir:

• Pregnancy.
• Problems with the kidneys and liver.
• Allergy to medications.

Self-medication is not recommended. A specialist should prescribe the intake and dosage of medications .

According to customer reviews, the most preferred generics of Ledipasvir in Russia are:

• LediHep by Zydus Heptiza.
• Hepcinat LP from Natco Pharma.
• MyHep LVIR from Mylan.
• Ledikast by Aprazer.
• Ledifos by Hetero.

Ledipasvir for the treatment of hepatitis C is not available separately from Sofosbuvir. Active components always go in tandem.

Hepatitis C Treatment Methods

In complex therapy of the disease the following are used:

• drug treatment;
• traditional methods;
• strict diet.

The main goals of treatment are: eliminating the inflammatory process in the liver, preventing the disease from progressing to cirrhosis. The choice of a specific treatment method depends on the following factors:

• patient's age;
• liver condition;
• nature of the disease.

Drug therapy

The main method of treating the disease is antiviral therapy, which involves the use of direct-acting medications. Hepatoprotectors are also prescribed without fail.

The corresponding tablets can increase the liver’s resistance to pathogenic factors. Hepatoprotectors made from glycyrrhizic acid are actively used. This active component is present in licorice root.

This is interesting: Hepatitis C: how long do people live with it? Life expectancy with and without treatment.

Folk remedies

A variety of traditional methods are used to treat the disease. This recipe is popular:

1. Unpeeled oat grains should be filled with a small amount of boiled water.
2. The resulting mixture is infused for 24 hours.
3. After this time, the product is filtered.

Oat infusion helps eliminate fatigue and improves the functions of the digestive system. The product should be drunk twice a day. The infusion reduces the load on the liver and helps eliminate toxic substances.

For hepatitis C, a decoction made from rose hips is also effective. The preparation process is as follows:

1. 200 grams of plant fruits are poured into 2 liters of boiling water.
2. The product is infused for 50 minutes.
3. After this time, the drink is filtered. The infusion is taken 100 ml twice a day.

Perennial daisy is used to prepare a medicinal infusion. 0.1 kg of grass leaves is poured into 0.2 liters of cool boiled water. The resulting mixture is infused for 20 hours. It is recommended to drink 0.1 liter of the drink twice a day. The average course duration is 2 weeks.

You need to brew tea from milk thistle flowers. The drink is consumed daily. Tea made from milk thistle flowers promotes the regeneration of damaged liver cells. The duration of treatment depends on the severity of the disease.

Diet

To enhance the effect of the pills, it is recommended to follow a proper diet. Main goals:

• normalization of organ functions;
• improving the flow of bile.

The patient should avoid fried foods. Preference is given to steamed dishes.

The amount of salt in the diet is limited. The following products are excluded from the daily menu:

• salinity;
• smoked meats;
• marinades;
• fatty meats;
• ice cream;
• baked goods;
• sweet carbonated water;
• animal fats;
• strong brewed tea;
• coffee;
• salty cheeses.

Alcoholic drinks, radishes, garlic, sorrel, and berries are also prohibited.

This is interesting: Why is hepatitis C called the gentle killer?

What side effects are there?

No significant side effects have been reported from taking Indian medications for the treatment of hepatitis C. This has been confirmed by numerous studies. The following adverse events were noticed by patients:

• Headache
• Disorders in the digestive system
• Lack of appetite
• Nervousness
• The appearance of migraine

If the patient has these effects, you should consult your doctor. He will review the dosage or regimen of the medication.

General information about the disease

Patients diagnosed with HCV are primarily concerned with where hepatitis C is treated and how much it costs. And this is absolutely correct, because the sooner the patient begins treatment, the greater his chances of making a full recovery. But before you find out how hepatitis C is treated and look for medications, you should learn as much as possible about the disease itself.

HCV is a viral liver infection that is commonly called the “gentle killer.” The causative agent of the disease is a flavavirus, resistant to many drugs. Most often, hepatitis C occurs in an asymptomatic chronic form, but in some cases the patient may complain of:

• Pain in the liver area
• Headache and general weakness
• Attacks of nausea and vomiting
• Developmental or persistent food aversion

Other symptoms of HCV include dark urine and discolored stool. Some patients report flu-like symptoms. If these symptoms appear, you should immediately contact a hepatologist or infectious disease specialist. Once the diagnosis of hepatitis C is confirmed, your doctor will help you choose the best treatment.

The study was supported by the research institute of the Indian pharmaceutical manufacturer Zydus Heptiza. Official website in Russia Zydus.ru

Indian generics for hepatitis C: where to buy

It is not possible to purchase medicines from India in municipal pharmacies. Medicines cannot be exported to Russia in bulk. Legally, you can only bring medicine for your own treatment.

The most reliable way to purchase Indian drugs for the treatment of hepatitis C is a trip to India . But not everyone can afford such luxury.

There is a way out of this situation: Indian tablets for hepatitis C can also be bought in Russia. For example, on the website of the official representative of the pharmaceutical company Zydus they offer high-quality medicines from the manufacturer.

When purchasing, be sure to pay attention: payment must be made through official methods, the packaging must be intact, in addition to the tablets, instructions for use must be included; There is a website where you can check whether medications are approved for sale in Russia.

You need to trust only reliable representatives, this will reduce the risk of purchasing counterfeits. buy medicine for hepatitis C from India officially and without risks on the following portals:

• InApteka is the largest distributor of Indian generics and original medicines. Wide selection of drugs, guarantees and high-quality information support.
• MyHepatit.com - order and express delivery of medicines at the price from the manufacturer. Opportunity to receive a free consultation with a hepatologist and learn more about viral hepatitis C.
• SoviHep.ru is a site for those who give preference to Zydus drugs. Let us remind you that only this pharmaceutical giant provides its clients with a Guarantee of Recovery. If the first course purchased does not help in treating hepatitis, the company will pay for corrective therapy.

On the portals listed above, you can buy generic drugs for hepatitis C with delivery from India, without leaving your hometown. The kit with drugs for the treatment of HCV includes convenient instructions in Russian and a full package of certificates of authenticity.

Interferon therapy regimens

Despite the wide variety of medications for hepatitis C in Russia, drugs based on interferon in combination with ribavirin are prescribed more often than others.

Interferon is an autogenous protein. There are various ways to obtain it, including from leukocytes. It has an antiviral and immunostimulating effect. Patients suffering from hepatitis C are given injections of interferon α-2a and 2b or pegylated interferon.

They are produced under different trade names:

• Reaferon-EC (contains interferon α-2a);
• lifefferon (contains interferon α-2b);
• algeron, pegintron (contain pegylated interferon).

Interferon α-2a and interferon α-2b differ from each other by one amino acid included in the composition. They have the following contraindications for use:

• individual intolerance;
• severe pathologies of the heart (including in the anamnesis), kidneys, liver, hematopoietic organs;
• diseases of the central nervous system, including epilepsy;
• hepatitis C, accompanied by cirrhosis in the decompensation stage.

When hepatitis C occurs, these drugs are used if the patient is taking immunosuppressants or has recently completed a course of treatment with them (unless there is a history of short-term steroid therapy).

They should be used with caution in children and pregnant women, and during therapy the baby should be switched to artificial feeding.

Interferon injections can cause a number of side effects, including: weakness, fever and chills, lack of appetite and weight loss, headaches, myalgia, arthralgia, dyspepsia, dry mouth, bloating, sleep problems, depression, allergies, heartburn, blurred vision, problems with the liver, including its inflammation, retinopathy, disorders of consciousness, pain and inflammation at the injection site.

Pegylated interferon contains polyethylene glycol, which extends the duration of action of the medication. If medications based on interferon α-2a and α-2b are administered either daily or every 3 days, then pegylated interferon is administered once a week. As a result, patients tolerate treatment more easily.

Ribavirin

Ribavirin is an antiviral drug that is available in the form of capsules and tablets for oral administration. Once in the body, the active substance blocks the enzyme responsible for the formation of viral RNA, as a result, the reproduction of the pathogen is stopped.

Before you start taking medicine for hepatitis, you need to take into account that it has a number of contraindications, such as:

• individual intolerance;
• history of severe heart pathologies, if they preceded therapy for at least six months;
• severe forms of depression, thoughts of suicide, attempts to commit suicide;
• pathologies of the thyroid gland that are not treated;
• renal failure with a glomerular filtration rate of less than 50 ml per minute;
• severe liver pathologies, including liver failure, cirrhosis in the stage of decompensation, autoimmune hepatitis;
• autoimmune pathologies;
• severe forms of anemia, including Cooley's anemia and sickle cell anemia;
• age under 18 years;
• breastfeeding period.

Ribavirin-based drugs cannot be treated while pregnant, as they cause congenital deformities of the fetus. Moreover, if a woman or her partner drank them, then planning a pregnancy is permissible only 7 months after completion of therapy.

Patients suffering from the following should take medicine for hepatitis C based on ribavirin with caution:

• heart pathologies;
• diabetes mellitus accompanied by ketoacidosis;
• severe pathologies of the pulmonary system, including chronic obstructive pulmonary disease;
• diseases that cause problems with blood clotting, including thrombophlebitis, pulmonary embolism;
• disorders of hematopoiesis in the bone marrow.

Due to the likelihood of developing lactic acidosis, therapy with a hepatitis C drug containing ribarin should be carried out in patients coinfected with HIV who are receiving antiretroviral medications.

Patients undergoing therapy with ribavirin-based medications should take into account that they can cause the following undesirable reactions:

• nervous system: headaches, vertigo, impotence, depression, aggression, irritability, increased activity, impaired consciousness, fainting, thoughts of suicide, insomnia;
• sensory organs: disturbance of taste, vision, hearing (up to deafness), hypertonicity of smooth muscles, sensitivity disorders, inflammation of the conjunctiva and middle ear, ringing in the ears;
• heart and blood vessels: hypotension or hypertension, increased or decreased heart rate, cardiac arrest;
• hematopoietic organs: decrease in the amount of all formed elements of blood;
• respiratory system: dyspnea, cough, inflammation of the throat, bronchi, paranasal sinuses, runny nose;
• digestive tract: dry mouth, loss of appetite, abdominal pain, excessive gas formation, pancreatitis, stomatitis, inflammation of the tongue, bleeding gums, increased levels of bilirubin in the blood, dyspeptic disorders;
• metabolism: malfunction of the thyroid gland (some patients need medications to help maintain its function), changes in the concentration of thyrotropin;
• musculoskeletal system: joint and muscle pain;
• genitourinary system: weakened libido, inflammation of the prostate, hot flashes, absence of menstruation, painful and heavy menstruation.

In addition, patients taking drugs for the treatment of hepatitis C based on ribavirin should expect the appearance of allergies, chest pain, disturbances in the structure of hair, increased hair loss, mycosis, viral infections, flu-like conditions, increased sweating, thirst, increased temperature, and enlarged lymph nodes.

During treatment, you need to remember that you should not take ribavirin simultaneously with antacid medications containing magnesium and aluminum ions (simethicone), since in this case the bioavailability of the antiviral agent decreases.

When ribavirin is prescribed simultaneously with didanosine, an increase in its toxic effect on the body may be observed, so it is prohibited to prescribe them in combination.

Since ribavirin takes a long time to be eliminated from the body, the likelihood of its pharmacological interaction with other medications is possible for another 2 months after the end of its use.

During treatment with ribavirin against hepatitis C, you need to regularly donate blood to assess the content of formed elements in it.

Fasting days without gallbladder

You can buy ribavirin at the pharmacy under different commercial names: rebetol, ribamidil, trivorin, lamivudine, ribapeg, arviron.

The doctor should decide which medicine to choose; you should not consult with patients taking similar medications, since they may not be suitable for you. Moreover, the doctor has more practical experience and knows better which medication helps more effectively. Indeed, despite the same content of ribavirin, these drugs differ in the composition of auxiliary components, degree of purity and tolerability.

In addition to these two medications, sometimes a new hepatitis drug based on boceprevir is included in the interferon therapy regimen. In Russia it can be purchased in the form of capsules under the trade name Viktrelis. This combination is more effective than interferon and ribavirin treatment alone. It also works well in patients who have been treated for hepatitis but have failed treatment or have had a relapse of infection.

The duration of such a triple therapy regimen can vary from 6 months to 1.6 years.

Another new drug that is included in the interferon regimen is called simeprevir. It is produced in capsules under the trade name Sovriad. The duration of the triple regimen with simeprevir is selected individually:

• if the patient has not previously received therapy for hepatitis, then his treatment is 12 weeks;
• for recurrent infection - 24 weeks;
• the longest course in the absence of effect from previous therapy is 48 weeks.

Another medication that is included in the interferon regimen is telaprevir, it is available in tablets under the trade name Insivo.

New drugs based on boceprevir, telaprevir and simeprevir are direct antiviral drugs that block the enzyme necessary for the synthesis of viral RNA.

They are indicated for the treatment of patients infected with genotype 1 hepatitis virus; they cannot be prescribed as monotherapy, but only in combination with drugs based on interferon and ribavirin.

In addition to antiviral drugs, patients suffering from hepatitis C are prescribed medications to help support the liver.