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Why I Do This

          

    It´s kind of been a whirlwind of thoughts and feelings since I gotten to the first project that I’ve been assigned to fly into. I´ve had to change my perspective on my goals and objectives here in this project and my time overall with MSF. I was assigned to improve the HIV/TB program in each of the projects I visit, but along with that, I have also been making myself helpful by working in the pediatric wards, which has been taking up the majority of my day.               The town is called Kalolele, there are no major roads to get here, and it is only accessible via helicopter or airplane. There are no vehicles in sight, only motorbikes. There is a road supposedly that one can use through motorbikes that would take one back to the capital, but it is rarely used and expensive. Kalole is a very young place, I’ve read in a project briefing that the median age here is about 19 years old. The majority of hospital admissions are children, which is why I am always in the pediatric wards in the usual morning. I feel like I’ve assimilated well in their medical team here and I look forward to helping and rounding with the local doctors. I´ve seen some difficult tropical medicine cases, such as cerebral malaria and many vaccine-preventable cases such as tetanus and measles. I have gotten a handful of new TB related cases every week, pulmonary and extrapulmonary TB. The majority of extrapulmonary TB I have seen are TB lymphadenopathy cases and one probable peritoneal TB case.               As for HIV, I am seeing a new diagnosis at least every two to three days. They have usually been in children, a few very young children below the age of two, usually presenting for fevers and having a positive malaria test, but due to their malnourish state, get tested for HIV. It made me more alert to re-present the guidelines for MSF to prevent mother to child transmission of HIV, which I will be presenting with one of the local nurses next week Tuesday. The local HIV nurse in charge of their program is great; she is hungry for knowledge, capable and tries to be as organized as she can in this kind of setting. Mind you though, there is no Wifi in the hospital and all of her records are hand-written which can be very tedious work. We´ve also made it a habit almost every weekday to meet at 4 PM to discuss an HIV/TB topic and talk about it so that she learns something new.               There is one case that I´ve been thinking about and is a constant reminder for me why I should and will always make the time to work in these settings in the future. There was a 15-year-old boy presenting about 10 days ago for a large swollen abdomen. Family says that his belly has been gradually getting bigger for the past 1 year, parents have tried traditional local medicine with no relief. They come from a town about 2 hours away using motorbike. On presentation the boy is in moderate distress, emaciated and appears about 10 years older than his stated age. Due to the high prevalence of tuberculosis in this setting, our first instinct as a team was to discuss the probability of TB-related peritoneal/abdominal disease. My first project in South Sudan had quite a number of these cases as the people living in that region drink unpasteurized milk, so Mycobacterium Bovis infection was quite common, and the presentation was very similar. Cases that I have seen responded well to anti-tuberculosis medication, so we started him on them right away.              

For all patients presenting with TB symptoms, we also run a panel of other tests, which includes the rapid antigen/antibody test for HIV and the antibody tests for both Hepatitis C and hepatitis B. To our surprise, the hepatitis C antibody test was positive. The viral hepatitis diseases are very difficult to treat at this level in the Congo. MSF, despite all the good that it aims to do for the people it wants to help, does usually have a narrow scope of aid. Treatment for Hepatitis B could be started, but Hepatitis C is a completely different story. Due to the lack of (financial) interest by pharmaceutical companies to make Hepatitis C treatment more accessible to all people, this child will likely die from liver failure secondary to hepatitis C. Now, I have no way of confirming whether this patient does have active disease or not; the hepatitis C test that I have been given to use does not confirm active disease, it just says whether the person has been exposed to Hepatitis C or not. In fact, there is a chunk of patients that will clear the virus on their own. But, if he does have active disease and the cause of his abdominal swelling (or ascites) is hepatitis C due to the liver starting to fail, he will eventually die from the disease.               This family has no means to go to the capital and seek treatment. The best we could do for this child is continue the course of TB medication, as long as can he tolerate it, treat his symptoms related to Hepatitis C with diuretics and paracenteses (abdominal puncture to let out fluid). He will be sent home this upcoming Monday with follow up at the local Ministry of Health clinic by his home. Him and his family were thankful for our help and services, but we emphasized as a team that his symptoms may continue to come back and that it may not be curable at this level. It´s very difficult to communicate this kind of news considering that this is my first French speaking project and that this family only speaks Swahili so all communication had to be dealt with a translator. Despite this saddening news, he was excited to go home and asked when he can go back to school.               It´s these kinds of cases and people that I have met in my life that leave a kind of thorn hanging on my side. It makes me uncomfortable thinking that we live in a world so capable to accepting this kind of injustice. Having a growing son and a family now, I want the best. I want my son to grow up, go to a nice school, become educated and live a life of relative comfort, but, its theses kinds of cases and situations that leaves a sense of discomfort thinking about that. It´s not like I shouldn´t want that for him either, its just that, this is the kind of world that we live in.               It´s all a roll of the dice.               It´s the luck of the draw.               It´s an unfortunate truth.               I want my son to somehow realize this as well. I want him to see that what he has, others do not have and that this life is only worth living if we can find a way to try to right these wrongs. I shouldn´t have to accept that this 15-year-old boy will die here in the Democratic Republic of Congo, but if he were to be in my family, if he were my son, he would live and reach his potential in the United States.                 But… this is why I do this.               This is why I am here.               I choose to see this.

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If Hep C positive, get viral load, Hep B panel (surface and core antigens. Epclusa and Mavyret treat all genotypes of hep C. Harvoni isn’t used much anymore. Epclusa (sofosbuvir/velpatasvir)is 12 weeks and can be taken with or without food; interacts with PPIs and H2 blockers. Mavyret (glecaprevir/pibrentasvir) is an 8-week treatment and must be taken with food; interacts with Seroquel.

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Find the Best Sofosbuvir Price on Hepatitis C Treatment

Hepatitis C is a serious disease that needs good medicine for treatment. Sofosbuvir is a drug that helps a lot in Hepatitis C. It is called Sovaldi in stores. Sofosbuvir with Ledipasvir is called Harvoni. It treats hepatitis C. Sofosbuvir Price $94,500 in the U.S. for 12 weeks. Generic versions cost around $300 in India. They are much cheaper. You can learn Sofosbuvir Buy Online it online. It will also talk about its cost. You will know about its dosage and side effects. Other important details will be included too.

Sofosbuvir Price in India

India sells cheap generic Sofosbuvir. It costs $10 to $20 per tablet. Hetero makes these generics, which are used worldwide. You can buy from Indian pharmacies, which cuts treatment costs drastically.

How Much Does Sovaldi Cost?

Sovaldi, also known as Sofosbuvir, is expensive. In the U.S., it costs $84,000 for 12 weeks. Patients often look for cheaper generic versions or buy them internationally. Generic versions cost around $300 in India.

Sofosbuvir 400 mg Velpatasvir 100 mg Price

Epclusa treats all hepatitis C types. It mixes Sofosbuvir and Velpatasvir. It costs $50 to $400 per pill based on location.

How Much Does Sofosbuvir Treatment Cost?

Sofosbuvir prices differ by country, pharmacy, and insurance coverage. In the U.S., it ranges from $28,000 to $84,000 per month. Generic options and international pharmacies provide more affordable alternatives.

Sofovir: A Cost-Effective Alternative

Sofovir, made via Hetero in India, is a cheaper generac of Sofosbuvir. It works similarly to Sovaldi but charges less. You should purchase Sofovir 400mg online with a prescription. It comes in a pack Of 28 tablets. Sofovir is utilized in India, the United States, the United Kingdom, and Russia.

What is the Age Limit for Sofosbuvir?

Sofosbuvir is for adults and youngsters aged 3 years and up. Doctors determine on the proper dose based totally on age, weight, and fitness. It's important to talk to a doctor about treatment for younger sufferers.

How Long is Sofosbuvir Treatment?

Sofosbuvir treatment time varies by hepatitis C type and health. It lasts 12 to 24 weeks. Sometimes, doctors add other medicines for better results.

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Sofosbuvir and Velpatasvir Price

The combined price of Sofosbuvir and Velpatasvir is less than to purchase the medications separately. In the international market, a one-month supply of the combination therapy can cost between $300 and $1000.It depends on the source. Generic versions provide a cost-effective alternative to the brand-name drug.

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The combination of Sofosbuvir and Velpatasvir 400/100 mg treats hepatitis C effectively. It's easy for patients to take. Buy from trusted online sources with prescription requirements.

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You can purchase Sofovir 400mg tablets online from certified Indian exporters. They have aggressive costs and ship internationally. Orders over $500 may additionally qualify for free transport. Make certain to have a valid prescription. When shopping for Sofovir online. Consult your physician for the proper dosage and treatment plan. Hepatitis C treatment can be steeply priced. But Sofovir 400 mg offers an effective and less costly choice. Prices are lowest in India, the USA, the UK, and Russia. They have worldwide access to this vital medicine.

Sofovir 400 mg Tablet Uses and Precautions

Sofovir treats Hepatitis C by stopping the virus from replicating. Patients must keep away from pregnancy and take precautions to prevent the spreading of the infection. It's important to apply Sofovir's most effectively beneath medical supervision for protection.

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It is crucial to follow the prescribed dosage for Sofovir 400 mg. If a dose is missed, take it as soon as possible unless. It is almost time for the next dose. Do not double the dose to make up for the missed one.

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A New Hope For Hepatitis C: Treatment Solutions In New Jersey

Understanding Hepatitis C and Treatment Advances Hepatitis C has gone from a disease not well understood to a disease we can cure in 90 days or less thanks to direct-acting antivirals. These medications are often well-tolerated and can be taken with many other medications. Two common medications utilized today are Epclusa (and its generic form sofosbuvir and velpatasvir) and Mayvret.

Epclusa: A Breakthrough in Hepatitis C Treatment Epclusa is a prescription medication used in the treatment of chronic hepatitis C virus (HCV) infection in adults. It is a combination of two direct-acting antiviral drugs: sofosbuvir and velpatasvir. The drug is manufactured by Gilead Sciences and was approved by the U.S. Food and Drug Administration (FDA) in June 2016.

Introduction to Epclusa

Mechanism of Action-Sofosbuvir belongs to a class of drugs known as nucleotide polymerase inhibitors, while velpatasvir is classified as an NS5A inhibitor. Together, these two components work synergistically to target different steps in the replication process of the hepatitis C virus.

Pan-Genotypic Treatment Option-Epclusa is known for its broad-spectrum activity against all major genotypes of hepatitis C virus, making it a pan-genotypic treatment option. This means that regardless of what version of Hepatitis C you have, Epclusa can treat it. This versatility has made Epclusa a popular choice for healthcare providers, simplifying the treatment decision-making process.

Treatment Duration and Versatility-One of the notable advantages of Epclusa is its high cure rates and the ability to offer a shorter treatment duration for many patients. The medication is taken orally once daily, typically for 12 weeks, although the treatment duration may vary based on individual factors such as HCV genotype, liver health, and previous treatment history.

Potential Side Effects and Monitoring-As with any medication, Epclusa may have potential side effects, and patients should be monitored during treatment. Common side effects may include headache, fatigue, and nausea. It’s essential for individuals considering or undergoing treatment with Epclusa to consult with their healthcare provider. The healthcare provider will assess the patient’s specific condition and determine the most appropriate treatment plan, considering factors such as potential drug interactions and the presence of any pre-existing medical conditions.

Mayvret Hep C: Transformative Dual-Action Treatment Mayvret Hep C, a combination of glecaprevir and pibrentasvir, represents a groundbreaking approach to tackling hepatitis C, a viral infection affecting the liver. Approved by regulatory authorities around the globe, this innovative treatment has become a game-changer in the fight against the hepatitis C virus (HCV). The unique combination of glecaprevir and pibrentasvir in Mayvret offers a potent antiviral punch, targeting different steps in the HCV lifecycle. This dual-action mechanism not only enhances the effectiveness of the treatment but also addresses the challenge of potential resistance that some traditional treatments may encounter. Many can achieve a cure with Mayvret after two months of treatment.

Comprehensive Hepatitis C Treatment Approach Hepatitis C treatment should not only focus on the disease but the total person. Other comorbidities and conditions should also be evaluated and treated to ensure the best possible outcome for the patient. If patients are currently suffering from Substance Use Disorder, it’s important that strategies in place to either cease substance use or design a plan so that the patient is using their substance(s) safely. Patients who are regularly injecting drugs should be educated on local programs like needle-exchanges to protect the patient from blood-blood transmission of diseases like hepatitis and HIV.

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Velakast (Sofosbuvir & Velpatasvir) | Generic Equivalant to EPCLUSA

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Essential Ingredient – Sofosbuvir & Velpatasvir

Product Name – Velakast

Manufacturer – APRAZER

Packing – Bank of 28 Tabs

Strenth in mg – 400/100mg.

Sofosbuvir & Velpatasvir is a combination of two anti viral medicine used for the treatment of long lasting viral infection of LIVER and chronic HEPATITIS C.Sofosbuvir & Velpatasvir combination medicines works by slowing down / stoping the HEPATITIS C virus from spreading inside the whole body.

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Looking for an affordable Hepatitis C treatment option? Epclusa is here! In the US, a 12-week treatment costs $74,760. However, Epclusa's generic version, velpatasvir sofosbuvir, is available in India at only $500. Get the same quality and effectiveness at a fraction of the cost. Contact Sunny Pharma to discuss the best treatment option for you.

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EPCLUSA

EPCLUSA HCV

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Harvoni combines ledipasvir, an HCV NS5A inhibitor, and sofosbuvir, an HCV NS5B polymerase inhibitor. It could cause your hepatitis C virus more durable to treatment with anti-viral medicines . If you could have a hepatitis B infection, using sofosbuvir and velpatasvir may trigger the virus to become more lively and won't assist your EPCLUSA remedy at all or it could cause demise. Test all sufferers for proof of current or prior hepatitis B virus infection before initiating remedy with sofosbuvir / velpatasvir. HBV reactivation has been reported in HCV/HBV coinfected patients who have been undergoing or had accomplished therapy with HCV direct appearing antivirals and weren't receiving HBV antiviral therapy. Some circumstances have resulted in fulminant hepatitis, hepatic failure, and death. mavyret generic

Founded in 2018, Asegua Therapeutics LLC is committed to providing larger access to therapies. Asegua Therapeutics LLC has launched a licensed generic of EPCLUSA® (sofosbuvir/velpatasvir) and an authorized generic of HARVONI® (ledipasvir/sofosbuvir). There are not any enough, nicely-managed studies in pregnant women who've taken Epclusa without ribavirin. Epclusa must be used during being pregnant only if the potential benefit justifies the potential danger to the fetus.

Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV therapy and submit-remedy comply with-up. Initiate acceptable affected person administration for HBV an infection as clinically indicated. Similar data had been used to assist dosing recommendations for pediatric topics with HCV genotype 1, 2, 3, 4, 5 or 6 an infection who have extreme cirrhosis. Sofosbuvir/velpatasvir in combination with ribavirin is indicated for the therapy of kids six years and older or weighing a minimum of 37 kilos with severe cirrhosis. Sofosbuvir/velpatasvir, bought under the model name Epclusa among others, is a hard and fast-dose mixture medication for the treatment of hepatitis C in adults. It is greater than 90% effective for hepatitis C genotypes one via six. It also works for hepatitis C in those who even have cirrhosis or HIV/AIDS.

Tell your doctor about all your present medicines and any drugs you start or stop utilizing. If you have ever had hepatitis B, utilizing sofosbuvir and velpatasvir may cause this virus to become active or get worse. You might have frequent liver operate checks while using this medicine and for a number of months after you stop. In one aspect, the method contains administering to the topic an interferon-free therapy routine comprising an effective amount of GS-7977 and an efficient quantity of ribavirin. In a specific aspect, the method is sufficient to provide an undetectable quantity of HCV RNA in the topic for at least 12 weeks after the tip of the time interval. During pregnancy, this medication ought to be used solely when clearly needed. Sofosbuvir/velpatasvir, together with ribavirin, must not be used during being pregnant by both the pregnant lady or her male associate.

A licensed pharmacist is aware of how so you better ask for advice from them on the way to properly dispose of EPCLUSA. If vomiting happens within 3 hrs after taking EPCLUSA, take one other dose. If it is already longer than 3 hrs since you could have taken the first one, then don't take another pill of EPCLUSA. Just proceed with the conventional dosage and circulate of your therapy. In case you are taking Ribavirin additionally whereas under EPCLUSA prescription, then there is a treatment guide you should follow from your well being professional, and that includes how many doses you ought to be taking. The data offered in this web site is for educational purposes and not meant to exchange a discussion or recommendation with a healthcare supplier.

Common unwanted side effects embrace complications, feeling drained, bother sleeping, and nausea. It has not been studied in pregnant ladies or during breastfeeding. Greater care is required in those who are also infected with hepatitis B. Sofosbuvir works by blocking the NS5B protein and velpatasvir works by blocking the NS5A protein. One tablet as soon as day by day, often for 12 weeks, with or without food.

Read the Patient Information Leaflet if obtainable from your pharmacist before you begin taking sofosbuvir/velpatasvir and every time you get a refill. It isn't known if this remedy can stop you from passing the virus to others. Do not share needles, and apply "safer sex" to lower the risk of passing the virus to others. “We count on to see a positive impression on sharing Medicaid markets during the second half of 2019. One means Gilead's doing that's through state-managed Medicaid plans. When Gilead first unveiled the generics initiative, Evercore ISI analyst Umer Raffat famous the corporate’s presence in Medicaid was very low, as Mavyret takes the lion’s share.

In patients with serologic evidence of HBV an infection, monitor for scientific and laboratory signs of hepatitis flare or HBV reactivation during HCV remedy with EPCLUSA and through publish-treatment comply with-up. Hepatitis B virus reactivation has been reported in HCV/HBV coinfected patients who have been undergoing or had completed treatment with HCV direct appearing antivirals, and who weren't receiving HBV antiviral remedy. Cases have been reported in patients who're HBsAg positive and in addition in sufferers with serologic evidence of resolved HBV infection (i.e., HBsAg negative and anti-HBc constructive). HBV reactivation has also been reported in patients receiving sure immunosuppressants or chemotherapeutic agents; the danger of HBV reactivation associated with therapy with HCV direct-acting antivirals may be elevated in these patients. Increases in indirect bilirubin up to three mg/dL above baseline have been noted among HIV-1/HCV coinfected subjects handled with EPCLUSA and an atazanavir/ritonavir-primarily based antiretroviral regimen. The elevated indirect bilirubin values weren't associated with scientific antagonistic occasions, and all topics completed 12 weeks of EPCLUSA without dose adjustment or remedy interruption of both EPCLUSA or HIV antiretroviral agents. In the Phase three trial with decompensated cirrhosis (ASTRAL-four), isolated, asymptomatic creatine kinase elevations larger than or equal to 10xULN were reported in 1% of subjects treated with EPCLUSA with ribavirin for 12 weeks.

LEDIPASVIR/SOFOSBUVIR is a prescription medicine used to treat adults with chronic hepatitis C genotype 1, four, 5 or 6 infection with or with out cirrhosis . In these with GT 1 and superior cirrhosis or with GT 1 or four with or with out cirrhosis who've had a liver transplant, LEDIPASVIR/SOFOSBUVIR is used with ribavirin. SOFOSBUVIR/VELPATASVIR is a prescription drugs used to deal with adults with chronic hepatitis C genotype 1, 2, 3, four, 5, or 6 infection with or with out cirrhosis . In these with superior cirrhosis , SOFOSBUVIR/VELPATASVIR is used with ribavirin.

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Velpanat Tablets: Sofosbuvir 400 Mg & Velpatasvir 100 Mg

Natco Pharma has started a generic Hepatitis C treatment drug in Nepal under the brand name 'Velpanat.'

The product is the first generic version of Sofosbuvir 400mg/Velpatasvir 100mg fixed-dose mixture sold by Gilead Sciences Inc under brand name Epclusa.

The Hyderabad-based firm has signed a non-exclusive licensing contract with Gilead Sciences Inc, to manufacture and sell generic versions of its chronic hepatitis C medicines in 101 developing countries.

Detail

Brand Name: Velpanat Tablets

Contents: Velpatasvir and Sofosbuvir

Marketed by: Natco Pharma Limited

Form: Tablets

Strength: Velpatasvir 100mg / Sofosbuvir 400mg

Packing: Pack of 28 tablets

Velpanat medicine is a mixture of sofosbuvir and velpatasvir. This medication performance by reducing the amount of hepatitis C virus in your body, which helps your protected system fight the disease and may help your liver recover.

Velpanat medicine price

PACK SIZE    PRICE    

28 Tablet/s       $478.80

56 Tablet/s       $957.60

84 Tablet/s       $1,434.00

Uses of Velpanat Tablet

Natco Sofosbuvir and Velpatasvir are applied to treat chronic (long-lasting) hepatitis C, a viral infection of the liver. It may sometimes use with another antiviral medicine (ribavirin).

Side Effects of Velpanat Tablet

Headache;

Nausea,     diarrhea; 

Tired     feeling;

Sleep     problems (insomnia).

Ask your doctor at once if you have

Slow     heartbeats;

Low     red blood cells-pale skin, weakness, rapid heart rate, trouble     concentrating.

Weak     or shallow breathing;

This is not a full list of all side effects that may happen. If you have questions about side effects, talk to your health care provider. Call your doctor for medical guidance about side effects.

What if you miss a dose?

If you miss a dose of Velpanat Tablets, get it as quickly as possible. If there is nearly time for your next, do not use two doses at once. If you miss more than one treatment, communicate with your doctor.

How Does Velpanat Tablets Work?

Velpanat Tablets contain Sofosbuvir 400mg and Velpatasvir 100mg. This medicine works by decreasing certain enzymes and aids in stopping hepatitis C viral. It improves liver function and lowers the damage.

Velpanat tablets Contraindications?

The list of application limitations is small, but it should treated with the full ability to avoid difficulties or adverse reactions of the body.

The manufacturer of the product guidance provides a list of contraindications to Velasof, which includes the following limitations:

Individual intolerance. In limited cases, there is an intolerance to one or more of the ingredients of the drug. The reaction can be not only to the active substances but also to the auxiliary ingredients of the medication.

Pregnancy, lactation. This limitation is associated with the risk of developing irreversible defects in the development of the fetus or newborn.

Children's Age: Treatment not prescribed to patients under the age of 18.

An individualized approach prescribed in the following cases:

1. for the treatment of patients older than 65 years;

2. In the presence of severe renal failure;

3. with diagnosed bradycardia;

4. during hemodialysis.

Extra limitations apply to the use of barrier methods of contraception during therapy to rule out conception. Also, a condom is mandatory for men taking Velpanat during intimacy with a pregnant woman.

To avoid unwanted results, therapy should be performed under the strict supervision of a doctor.

The reason for this limitation is the possibility of negative interaction. So, some medications can significantly reduce the effect of anti-hepatitis therapy or completely neutralize the action of active components of Velpanat, cause side effects.

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Velpanat Tablet related warnings.

Kidney

Velpanat 400mg/100mg Tablet should used with caution in patients with severe kidney disease. Dose adjustment of Velpanat 400mg/100mg Tablet may be needed. Please ask your doctor. Limited information is available on the use of Velpanat 400mg/100mg tablets in these patients. No dose adjustment recommended in patients with mild to moderate kidney disease.

Liver

Velpanat 400mg/100mg Tablet is safe to use in patients with liver disease. No dose adjustment of Velpanat 400mg/100mg Tablet prescribed. However, inform your doctor if you have any kidney disease as regular monitoring of liver function tests may be recommended in some patients while using this medicine.

Alcohol

Interaction with alcohol is unknown. Please consult your doctor.

Pregnancy

Velpanat 400mg/100mg Tablet is probably safe to use during pregnancy. Animal studies have shown low or no adverse effects on the fetus. However, there are limited human studies. Please consult your doctor.

Lactation

Velpanat 400mg/100mg Tablet is probably safe to use during lactation. Limited human data implies that the drug does not represent a significant risk to the baby.