Myhep Dvir Tablet

Myhep Dvir Tablet is a potent fixed-dose combination direct-acting antiviral (DAA) containing Sofosbuvir 400mg and Daclatasvir Dihydrochloride 60mg, manufactured by Mylan Pharmaceuticals Private Limited. It is indicated for the treatment of chronic Hepatitis C Virus (HCV) infection across multiple genotypes (1–6) in adult patients. Available from Shabbir Medical Hall at the best price in India, this genuine prescription tablet is available online with fast delivery nationwide.

BENEFITS: Myhep Dvir provides a highly effective, interferon-free oral regimen combining two complementary antiviral mechanisms. Sofosbuvir, a nucleotide analogue inhibitor of the HCV NS5B RNA-dependent RNA polymerase, halts viral RNA replication at the core enzymatic level. Daclatasvir, an NS5A replication complex inhibitor, prevents HCV RNA replication, virion assembly, and release. Together, this dual-mechanism approach delivers high rates of Sustained Virological Response at 12 weeks post-treatment (SVR12) — the accepted definition of HCV cure — across genotypes 1, 2, 3, 4, 5, and 6, with or without ribavirin depending on patient profile.

USAGE OVERVIEW: Myhep Dvir Tablets are taken orally, once daily, with or without food, for a treatment duration of 12 to 24 weeks as determined by the treating gastroenterologist/hepatologist based on HCV genotype, prior treatment history, and presence of cirrhosis. The standard regimen is one tablet of Sofosbuvir 400mg + Daclatasvir 60mg once daily. Ribavirin may be added in patients with genotype 3, advanced cirrhosis, or prior treatment failure.

SAFETY OVERVIEW: The most common side effects include fatigue, headache, nausea, and insomnia. Serious adverse events are rare but include severe bradycardia when co-administered with amiodarone, and risk of HBV reactivation in patients with hepatitis B co-infection. Liver function, HCV viral load (SVR4 and SVR12), renal function, and full blood count monitoring are required during and after therapy. This medicine is NOT recommended for children below 3 years of age without specialist guidance.

Uses / Indications:

PRIMARY USES:
• Chronic Hepatitis C Virus (HCV) genotype 1: with or without ribavirin (12–24 weeks)
• Chronic HCV genotype 2: 12 weeks (without ribavirin in most patients)
• Chronic HCV genotype 3: 12 weeks + ribavirin (compensated cirrhosis or treatment-experienced); 24 weeks in select cases
• Chronic HCV genotype 4, 5, 6: 12 weeks (with or without ribavirin per hepatologist guidance)
• HCV-HIV co-infected patients: same genotype-based regimens as mono-infected patients

ADDITIONAL USES:
• HCV in patients with compensated cirrhosis (Child-Pugh A): with ribavirin as directed
• HCV in liver transplant recipients: under specialist supervision
• Re-treatment of prior DAA-naive treatment failures (interferon-based prior therapy)

Interactions / Warnings:

HEPATITIS B REACTIVATION WARNING (BLACK BOX EQUIVALENT):
Screen ALL patients for current or prior HBV infection (HBsAg, anti-HBc, anti-HBs) before starting Myhep Dvir. Fatal hepatitis B flares have occurred in patients co-infected with HCV and HBV upon HCV treatment. Monitor HBV DNA and liver function regularly during and after HCV treatment. Initiate HBV antiviral therapy as appropriate before or during HCV treatment in HBV co-infected patients.

CARDIAC MONITORING:
If amiodarone or other antiarrhythmics cannot be avoided: inpatient cardiac monitoring for first 48 hours; outpatient or self-monitoring for at least 2 weeks after initiation. Inform all treating cardiologists of HCV treatment.

RENAL IMPAIRMENT:
Sofosbuvir is renally cleared — use with caution in severe renal impairment (eGFR <30 mL/min) or ESRD on dialysis; insufficient safety data; alternative regimens may be preferable.

HEPATIC IMPAIRMENT:
Compensated cirrhosis (Child-Pugh A): can be used with extended duration + ribavirin. Decompensated cirrhosis (Child-Pugh B or C): specialist-only use; safety data limited.

DRIVING & MACHINERY:
Fatigue and dizziness may occur; assess personal response before driving.

Pregnancy interaction:

PREGNANCY SAFETY:
• Sofosbuvir and Daclatasvir: limited human pregnancy data
• Animal studies with daclatasvir showed embryo-foetal toxicity at high doses — use during pregnancy only if clearly necessary under specialist guidance
• If ribavirin is added to the regimen: ribavirin is CONTRAINDICATED in pregnancy and in male partners of pregnant women (teratogenic and embryolethal) — two effective contraceptive methods required during treatment and for 6 months after
• Test for pregnancy before initiating ribavirin-containing regimens

BREASTFEEDING:
• It is unknown whether sofosbuvir or daclatasvir are excreted in human milk
• Risk to infant cannot be excluded — consult hepatologist before breastfeeding during treatment

CONTRACEPTION WARNING:
• Females of childbearing potential: use effective contraception during treatment
• If ribavirin is included: two forms of effective contraception mandatory during and for 6 months post-treatment (both patient and male partner)

Expert advice:

PHARMACIST BEST PRACTICES:

1. NO FOOD RESTRICTION — BUT TAKE AT THE SAME TIME DAILY:
• Myhep Dvir can be taken with or without food, which greatly simplifies adherence. However, taking it at the same time every day is essential to maintain consistent plasma drug levels of both sofosbuvir and daclatasvir. Set a daily phone alarm to build a fixed dosing habit from day one of treatment.

2. COMPLETE THE FULL TREATMENT COURSE WITHOUT INTERRUPTION:
• HCV DAA therapy requires strict adherence for 12–24 consecutive weeks. Interrupting treatment — even briefly — dramatically increases the risk of virological breakthrough and resistance-associated substitutions (RASs) that may limit future treatment options. If you need to stop for any reason, consult your hepatologist immediately before doing so.

3. AMIODARONE WARNING — CARDIAC EMERGENCY RISK:
• If you are taking or have recently taken amiodarone (for heart rhythm disorders), inform your hepatologist BEFORE starting Myhep Dvir. This combination can cause life-threatening slowing of the heart rate (severe bradycardia). This interaction extends to other antiarrhythmics — always disclose your complete cardiac medication list.

4. HEPATITIS B SCREENING IS MANDATORY BEFORE STARTING:
• All patients must be tested for Hepatitis B (HBsAg and anti-HBc) before initiating Myhep Dvir. Treating HCV can paradoxically trigger a serious, potentially fatal Hepatitis B flare in co-infected patients if HBV is not simultaneously managed. Do not start treatment without confirmed HBV status and appropriate preventive measures.

5. HERBAL SUPPLEMENTS CAN DESTROY TREATMENT EFFICACY:
• St John's Wort (a commonly used herbal antidepressant) is an absolute contraindication with Myhep Dvir. It drastically reduces daclatasvir plasma levels, potentially rendering the entire HCV treatment ineffective. Inform your doctor about ALL herbal products, vitamins, and supplements before starting.

MONITORING ADVICE:
• HCV RNA (viral load): Baseline, Week 4 (early virological response), end of treatment, SVR4, and SVR12 (12 weeks post-treatment = cure assessment)
• Liver Function Tests (ALT, AST, bilirubin, albumin): Baseline and at 4-week intervals during treatment
• HBV DNA and HBsAg: Baseline; monitor during treatment if HBsAg positive or anti-HBc positive
• Renal function (serum creatinine, eGFR): Baseline and periodically
• Full Blood Count (FBC): Especially if ribavirin added — monitor for haemolytic anaemia
• Cardiac monitoring: Mandatory if patient has cardiac history or is on antiarrhythmic drugs

COMPLIANCE TIPS:
• Keep a treatment diary noting dose time, any symptoms, and upcoming test dates
• Store tablets in original packaging away from moisture, heat, and sunlight
• Carry your hepatologist's prescription and a medication card at all times
• Do NOT crush, split, or chew tablets — swallow whole with water
• Inform ALL treating doctors (cardiologist, GP, dentist) that you are on Myhep Dvir

SAFETY TIPS:
• Do NOT stop Myhep Dvir without consulting your hepatologist
• Maintain all scheduled hepatology appointments and blood tests without delay
• If ribavirin is part of your regimen: use effective contraception throughout and for 6 months after completion
• Avoid alcohol during HCV treatment to reduce additional hepatic stress
• Report any unusual heartbeat, extreme fatigue, jaundice, or dark urine to your hepatologist immediately

Side Effects:

COMMON SIDE EFFECTS (>1 in 10 people):
• Fatigue, headache — most frequently reported
• Nausea, diarrhoea, abdominal discomfort
• Insomnia, irritability
• Chills, anaemia (particularly when used with ribavirin)
• Elevated bilirubin (mild, transient)

SERIOUS SIDE EFFECTS (contact your doctor immediately):
• Severe Bradycardia / Heart Block: life-threatening when Myhep Dvir is co-administered with amiodarone (or other antiarrhythmic agents) — monitor cardiac function closely; AVOID amiodarone co-administration
• Hepatitis B Reactivation: HBV can reactivate in patients with resolved HBV infection — screen all patients for HBsAg and anti-HBc before starting therapy; fatal hepatitis B flares have been reported
• Lactic Acidosis (rare with sofosbuvir): unexplained weakness, breathing difficulty, abdominal pain — discontinue immediately

EMERGENCY SIGNS — SEEK IMMEDIATE MEDICAL HELP:
• Sudden slowing of heartbeat, dizziness, fainting (bradycardia)
• Jaundice, dark urine, severe abdominal pain (HBV reactivation / hepatotoxicity)
• Extreme weakness, difficulty breathing (lactic acidosis)

How to use:

DOSAGE GUIDANCE (always as directed by your gastroenterologist/hepatologist):
• Genotype 1, 4, 5, 6 (treatment-naive, no cirrhosis): Sofosbuvir 400mg + Daclatasvir 60mg ONCE DAILY for 12 weeks
• Genotype 2 (all patients): Sofosbuvir 400mg + Daclatasvir 60mg ONCE DAILY for 12 weeks
• Genotype 3 (treatment-naive, no cirrhosis): Sofosbuvir 400mg + Daclatasvir 60mg ONCE DAILY for 12 weeks ± ribavirin
• Genotype 3 (cirrhosis or treatment-experienced): 24 weeks + ribavirin as directed

ROUTE OF ADMINISTRATION:
• Oral (film-coated tablet) — swallow whole with water
• Can be taken WITH or WITHOUT food — no food restriction

TIMING:
• Take at the same time each day for consistent drug plasma levels
• Consistency is critical — irregular dosing significantly increases risk of virological failure

MISSED DOSE:
• If missed within 18 hours of usual time, take immediately
• If more than 18 hours have passed, skip the missed dose and resume at the next scheduled time
• NEVER double up doses

STORAGE:
• Store below 30°C in a dry place, away from moisture and sunlight
• Keep in original packaging
• Keep out of reach of children
• Do not use after the expiry date printed on the label

How it works:

Mechanism of Action:
Myhep Dvir Tablet contains two direct-acting antivirals (DAAs) targeting two essential HCV replication proteins:

1. SOFOSBUVIR 400mg — NS5B RNA-Dependent RNA Polymerase Inhibitor:
• A nucleotide prodrug activated intracellularly to its active triphosphate form (GS-461203)
• Acts as a defective substrate for the HCV NS5B polymerase — once incorporated into the growing RNA chain, replication terminates
• Pan-genotypic activity: effective across HCV genotypes 1–6
• High barrier to resistance; clinically significant resistance-associated substitutions (RASs) are rare

2. DACLATASVIR DIHYDROCHLORIDE 60mg — NS5A Replication Complex Inhibitor:
• Binds to HCV NS5A protein, disrupting its role in viral RNA replication, assembly, and secretion of infectious virions
• Prevents formation of the membranous web replication complex critical for HCV life cycle
• Active across genotypes 1–6, with highest potency against genotypes 1 and 3
• Picomolar potency — among the most potent HCV inhibitors available

COMBINED EFFECT:
• Dual blockade of NS5B + NS5A = rapid, deep HCV viral suppression
• Undetectable HCV RNA typically achieved within 4 weeks of treatment
• SVR12 rates of 90–100% across most genotypes in clinical trials
• Interferon-free, ribavirin-sparing option for most patients — excellent tolerability

Faq for medicine:

1. What is Myhep Dvir Tablet used for?
Myhep Dvir (Sofosbuvir 400mg + Daclatasvir 60mg) is a direct-acting antiviral combination used to treat chronic Hepatitis C virus (HCV) genotypes 1–6 in adults, taken once daily for 12–24 weeks as directed by a gastroenterologist or hepatologist.

2. How does Myhep Dvir Sofosbuvir Daclatasvir Tablet work?
Sofosbuvir inhibits the HCV NS5B RNA polymerase, blocking viral RNA replication; Daclatasvir inhibits NS5A, disrupting replication complex assembly and virion release. Together they suppress HCV to undetectable levels, achieving cure (SVR12) in 90–100% of patients across genotypes.

3. What is the dose of Myhep Dvir Tablet for Hepatitis C?
Standard dose: ONE tablet (Sofosbuvir 400mg + Daclatasvir 60mg) orally ONCE DAILY with or without food, for 12–24 weeks depending on HCV genotype, cirrhosis status, and prior treatment history. Always follow your hepatologist's prescription exactly.

4. What are the side effects of Myhep Dvir Tablet?
Most common: fatigue, headache, nausea, insomnia, chills. Serious but rare: severe bradycardia with amiodarone (avoid co-use), Hepatitis B reactivation in co-infected patients. Screen for HBV before starting and avoid St John's Wort throughout treatment.

5. Can I buy Myhep Dvir Tablet online at the best price in India?
Yes. Buy Myhep Dvir online from Shabbir Medical Hall at 40% OFF MRP (Rs 9,815 vs Rs 16,359.40 per pack of 28 tablets). Valid hepatologist/gastroenterologist prescription required. Fast delivery across Hyderabad, Bangalore, Mumbai, Delhi, and Chennai.

Medicine interaction:

CRITICAL DRUG INTERACTIONS:
• Amiodarone: CONTRAINDICATED — severe symptomatic bradycardia and heart block, including fatal cases, have been reported with SOF-based regimens; avoid co-administration
• Strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, oxcarbazepine, St John's Wort): significantly reduce daclatasvir plasma levels — CONTRAINDICATED or requires dose adjustment under specialist guidance
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, HIV protease inhibitors with ritonavir/cobicistat): increase daclatasvir levels — reduce DCV dose to 30mg/day under specialist guidance
• P-gp inducers (rifampicin): reduce sofosbuvir levels — AVOID
• Antacids / H2 blockers / PPIs: no significant interaction with Myhep Dvir (unlike some other DAAs)
• Metformin: sofosbuvir may increase metformin exposure via renal transporter competition — monitor blood glucose

VACCINE INTERACTIONS:
• No specific vaccine interactions documented for Myhep Dvir; however, inform your hepatologist of any planned vaccinations during treatment

SUPPLEMENT INTERACTIONS:
• St John's Wort (Hypericum perforatum): potent CYP3A4/P-gp inducer — ABSOLUTELY CONTRAINDICATED
• Always inform your doctor of all vitamins, herbal products, and supplements