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Dosage Modification
Reduction of sofosbuvir dose not recommended
Discontinue sofosbuvir therapy if the agents used in combination
are discontinued
Genotypes 1 and 4
Serious adverse reactions potentially related to peginterferon alfa
and/or ribavirin: Should reduce or discontinue dose of
peginterferon alfa and/or ribavirin following the recommendations
of their respective prescribing information
Genotypes 2 and 3
Serious adverse reaction potentially related to ribavirin: Modify or
discontinue ribavirin dose
Hemoglobin <10 g/dL without cardiac disease: Reduce ribavirin
dose to 600 mg/day PO divided BID with food
Hemoglobin <8.5 g/dL without cardiac disease: Discontinue
ribavirin
Cardiac disease and hemoglobin decreased ≥2 g/dL during 4
week period: Reduce ribavirin dose to 600 mg/day PO divided BID
with food
Cardiac disease and hemoglobin <12 g/dL despite 4 weeks at
reduced dose: Discontinue ribavirin
After discontinuing the dose may attempt to restart ribavirin at
600 mg PO divided bid and further increase it to 800 mg PO
divided bid; increasing the dose to 1000 - 1200 mg/day not
recommended