With Sofosbuvir and Daclatasvir the world “got lucky” in that these drugs happen to be in the 30% of medicines that you can take by mouth and get into the body easily. This is called “oral bioavailability” and relates to:
- Water solubility
- Gut permeability
A drug that dissolves well in water and crosses the gut easily is in what is called BCS class I and when taken by mouth it gets into the body fine.
MOST DRUGS ARE NOT LIKE THIS and need help. Pharmaceutical companies provide that help by using various techniques called formulation. Here is some background on this:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399483/
http://www.sciencedirect.com/science/article/pii/S1818087614000348
With this in mind is the background on Telaprevir:
http://www.nature.com/nbt/journal/v29/n11/fig_tab/nbt.2020_F3.html
As you may not, Telaprevir is less soluble than marble and a great deal of work was required to convert it into a form that was bioavailable.
Looking at the other HCV drugs.
Ledipasvir will work provided it has a very small particle size and hits an acid stomach (which increases it’s solubility). We know this from practical experience but it is on the borderline of the doable.
Velpatasvir is insoluble and must be formulated.
Simeprevir is insoluble, so must be Simeprevir Sodium but then there is a problem with related substance C – a toxic impurity that even the originator required an exemption on the normal limits to get the medicine to market.
Now everyone here is an adult, and it would be fair to say there’s a bit of anti-pharma sentiment due to their pricing policies, but please keep in mind that there is complex science that underpins making many medications bioavailable.
Unless there is a good reason (financial or import access) using factory formulated medicine is sensible. If you plan this route choose Sofosbuvir+Daclatasvir in preference to Ledipasvir as there is more wiggle room and don’t kid yourself it will just work with some of the other HCV molecules because it won’t.
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