You are a pharmacist at a specialist outpatient clinic. You received a prescription for sofosbuvir plus weight based ribavirin x 24 weeks for a 39 year old lady with hepatitis C.

a) What information would you obtain prior to dispensing this medication? (4 marks)

b) How would you counsel this patient on the common adverse effects of sofosbuvir and ribavirin? (6 marks)

c) At what time points would you recommend to check and monitor the patient’s hepatitis C RNA level? (3 marks)

d) Three months after the initiation of the sofosbuvir and ribavirin treatment, the physician would like to discontinue ribavirin as the patient can not tolerate its side effects. Please recommend another active agent to be used in conjunction with sofosbuvir to treat heptatitis C. (2 marks)