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Direct-acting antivirals in India: sofosbuvir, velpatasvir and daclatasvir | CION Cancer Clinics
Hepatitis C is curable with a short course of tablets called direct-acting antivirals, most often sofosbuvir combined with velpatasvir or daclatasvir. Indian generic versions have made treatment far cheaper, and the national programme offers it at government centres. This page explains the medicines, the checks before you start, what moves the cost, and why people with cirrhosis still need liver cancer scans after the virus is gone. At CION Cancer Clinics, our specialists help you understand your own risk and plan regular liver checks that fit it.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- What are direct-acting antivirals, and do they work?
- Which hepatitis C tablets are used in India?
- What happens before, during and after a course of tablets?
- How much does hepatitis C treatment cost in India, and where can I get it?
- What do people often get wrong about hepatitis C tablets?
- Who are these tablets not suitable for, or not straightforward for?
- What this page cannot tell you
- Common questions about hepatitis C tablets
The short answer
What are direct-acting antivirals, and do they work?
Direct-acting antivirals are tablets that stop the hepatitis C virus from copying itself. Taken daily for a short course, usually about twelve weeks, they clear the virus in most people who finish them.
Why this changed everything in India
The older treatment was months of injections that many people could not tolerate and that often failed. Today the tablets are made by several Indian companies as generics. That has brought the price down sharply, and the government's national viral hepatitis programme offers testing and treatment at designated public centres.
What the tablets do not do
They remove the virus. They do not remove scarring that has already built up. Someone whose liver had cirrhosis before treatment still carries a raised risk of liver cancer after the virus has gone, and needs regular scans. This is the part of the story that families most often miss, and it is why a cancer clinic writes about hepatitis C at all.
Antiviral treatment is prescribed and supervised by a hepatologist or a physician who treats hepatitis. CION coordinates this through partner hepatologists.The medicines
Which hepatitis C tablets are used in India?
Almost every course is built around sofosbuvir, paired with a second medicine. Your doctor chooses the pairing.
Sofosbuvir with velpatasvir
Often given as one combined tablet. It works against every strain of the virus, so a genotype test is often not needed first. It is the backbone of many public programmes.
Sofosbuvir with daclatasvir
Two separate tablets, widely available as Indian generics. It is also used across strains, and remains common in India.
Ribavirin added
An older medicine sometimes added for people with advanced cirrhosis or a previous failed course. It needs closer blood monitoring, because it can cause a low blood count.
It must not be taken in pregnancy, by either partner trying to conceive.If a first course fails
A different combination is used. Some retreatment medicines are less easily available in India and may need to be arranged specially. Your hepatologist will explain what is possible.
Not sure whether this applies to you?
Ask an oncologistStart to finish
What happens before, during and after a course of tablets?
Confirm the infection is active
A positive antibody is not enough. An HCV RNA test must find the virus. Our page on reading a hepatitis C report explains the difference.
Check the liver and the other medicines
The doctor checks for scarring, tests for hepatitis B and reviews every medicine and supplement you take. Hepatitis B can flare up when hepatitis C is treated, so it is checked first.
Take every tablet, every day
Missing doses is the commonest reason treatment fails. Do not stop because you feel well. Most people feel little from the tablets beyond headache or tiredness.
Test again after finishing
An RNA test some weeks after the last tablet shows whether the virus has gone for good. If you have cirrhosis, liver cancer surveillance continues after that.
Side by side
How much does hepatitis C treatment cost in India, and where can I get it?
Government programme
Private prescription
Testing and tablets offered at designated public centres
You pay for tests, consultations and tablets yourself
Eligibility and centres are set by the programme and change
Price varies by brand, pharmacy and the length of the course
Follow-up tests usually arranged at the same centre
Scans, RNA tests and scarring checks are quoted separately
Check the current rules with the centre before you go
Ask for a written, itemised estimate before starting
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Commonly believed
What do people often get wrong about hepatitis C tablets?
"I can buy the tablets at a pharmacy and skip the tests."
Without the tests, nobody knows whether the infection is active, whether hepatitis B is present, or whether your other medicines clash with the tablets. Those checks keep treatment safe.
"I feel better, so I can stop early."
Hepatitis C rarely causes symptoms, so feeling well tells you nothing about the virus. Stopping early gives it a chance to come back and can make a second course harder.
"Generic tablets are weaker than the original brand."
Approved generics contain the same medicine. Buy from a licensed pharmacy on a doctor's prescription, and keep using one source through the course if you can.
"Once the virus is cleared, I never need another liver check."
That is true for many people without cirrhosis. If your liver was already scarred, your risk of liver cancer stays raised, and regular scans are still advised. Read why surveillance continues.
Who needs extra care
Who are these tablets not suitable for, or not straightforward for?
Most adults with active hepatitis C can be treated. Some groups need a specialist plan, a different combination or a delay, and should not start on a pharmacy course alone.
People taking amiodarone
This heart rhythm medicine can cause a dangerously slow heartbeat when taken with sofosbuvir. Tell the doctor about every heart medicine.
Advanced or decompensated cirrhosis
If you have fluid in the abdomen, jaundice, confusion or bleeding varices, treatment is planned by a hepatologist, sometimes alongside a transplant assessment. Some medicine combinations are not safe in a failing liver.
Pregnancy, children and severe kidney disease
Treatment is usually not given during pregnancy and is planned for after delivery. Children and people on dialysis are treated, but by specialists who adjust the plan.
People who already have liver cancer
The timing of antiviral treatment alongside cancer treatment is a decision for the whole team. Read hepatitis C treatment when you already have cancer.
Being straight with you
What this page cannot tell you
It cannot tell you which combination you should take, or for how long. That depends on your liver, your previous treatment, your kidneys and every other medicine you use. Only the hepatologist or physician who has seen your reports can decide it. This page gives no doses on purpose.
It cannot quote you a price
Prices for generic tablets change, and differ by brand and pharmacy. The tests before and after treatment add to the bill. The government programme changes its centres and rules from time to time, so check what applies when you go. Our page on free or subsidised treatment in Telangana explains where to ask.
It cannot tell you your cancer risk
That depends mostly on how scarred the liver was before the virus was cleared. A doctor who knows that answer can tell you whether you need surveillance and how often.
If you are unsure where to start, call the helpline. Someone will tell you which doctor to see first.Questions we are asked
Common questions about hepatitis C tablets
Is hepatitis C really curable with tablets?
Yes. For most people who take the full course, the virus is gone for good, confirmed by an RNA test after treatment ends. The tablets do not protect you from a new infection, and they do not undo cirrhosis. That is why some people still need regular liver checks afterwards.
Do I need a genotype test before starting?
Often not. Sofosbuvir with velpatasvir and sofosbuvir with daclatasvir both work across strains, and many Indian programmes treat without a genotype. It may still be ordered if you have cirrhosis or an earlier course failed. Your doctor will decide whether it adds anything in your case.
What side effects should I expect?
Most people notice little. Headache, tiredness, nausea and trouble sleeping are the commonest complaints, and they tend to be mild. Ribavirin, when added, causes more problems, including a low blood count. Tell your doctor about anything that worries you rather than stopping the tablets.
Can I drink alcohol during treatment?
It is best avoided. Alcohol adds its own damage to a liver already hurt by the virus, and it raises the risk of liver cancer in people with scarring. If cutting down is hard, say so to your doctor. Help is available, and nobody should judge you for asking.
What if I miss a dose?
Take it when you remember on the same day, then carry on as normal. Do not take two doses together. If you miss several days, call the doctor who prescribed the tablets. A phone alarm, or a family member who checks each evening, helps many people finish the course.
Can my family catch hepatitis C from me during treatment?
Hepatitis C spreads through blood, not through food, utensils or hugging. Do not share razors, toothbrushes or nail clippers. Family members who may have had a blood exposure can ask about testing. Read our page on testing the family.
Are herbal liver tonics safe with these tablets?
Some herbal products can harm the liver, and that harm is most dangerous in a scarred liver. Some may also interact with the tablets. Tell your doctor everything you take, including tonics and supplements. You will not be judged for it, and it helps keep treatment safe.
Where does CION fit in?
CION's oncologists see people whose hepatitis C has left cirrhosis or a scan finding. We plan liver cancer surveillance, review worrying scans at the tumour board and coordinate antiviral care through partner hepatologists. Call the CION helpline if you are not sure who to see first.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- World Health Organization — Hepatitis C
- National Viral Hepatitis Control Program (MoHFW) — National Viral Hepatitis Control Program
- Liver UK (formerly British Liver Trust) — Hepatitis C
- NHS — Hepatitis C
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Reading a hepatitis C reportCheck the infection is active before treatmentWhat sustained virological response meansHow you know the tablets have workedFree or subsidised hepatitis C treatment in TelanganaWhere the government programme treats peopleSurveillance after hepatitis C treatmentThe scans that continue if you have cirrhosis
Talk to us
Cleared hepatitis C but told you have cirrhosis?
We can plan liver cancer surveillance with you and review any scan that has raised a question. Tell us what your reports say and we will suggest the next step. One helpline serves every CION centre.