Common side effects are fatigue, headache, nausea, rash, irritability, dizziness, back pain, and anemia. Seems like your pronunciation of crassulacean is not correct. The design of sofosbuvir, based on the ProTide approach, avoids this slow step by building the first phosphate group into the structure of the drug during synthesis. or pronounce in different accent or variation ? Sept 12, 2015. [30] Dephosphorylation creates the inactive metabolite GS-331077. [59], In Switzerland the price is fixed by the state every three years. For the treatment of cases with cirrhosis or liver transplant patients, weight-based ribavirin is sometimes added. Definition and synonyms of metabolism from the online English dictionary from Macmillan Education. The half life of sofosbuvir is 0.4 hours, and the half life of GS-331077 is 27 hours. The duration of treatment is typically 12 weeks. Register [46] In 2014 the list price of 12 weeks combination treatment with a sofosbuvir-based regimen sosbuvir ranges from US$84,000 to $94,000. [8], Plasma protein binding of sofosbuvir is 61–65%, while GS-331077 has minimal binding. [7] It is taken by mouth. [80][81][6] That treatments could be conducted at very low costs was demonstrated by Hill and coworkers who presented data on 1,160 patients who used generic versions of solfosbuvir, ledipasvir, plus daclatasvir from suppliers in India, Egypt, China and other countries and reported over 90% success at costs of about $50 per therapy. [44] It had signed licenses with generic manufacturers by September 2015. [57], Unlike other comparable Western developed countries, sofosbuvir is far more affordable in Japan and South Korea at approximately $300 and $5900 respectively for a 12-week treatment, with each government covering 99% and 70% of the cost respectively. [75] In particular, Doctors of the World argue that the Protide technology powering sofosbuvir has been previously invented by the Chris McGuigan team at Cardiff University in the UK, and that the Gilead drug is not therefore inventive. [33], In 2014 the fixed dose combination drug sofosbuvir/ledipasvir, the latter a viral NS5A inhibitor, was approved; it had also been granted breakthrough status. [3] Side effects are generally more common in interferon-containing regimens. How to pronounce metabolism. {{app.userTrophy[app.userTrophyNo].hints}}. GS-461203 serves as a defective substrate for the NS5B protein, which is the viral RNA polymerase, thus acts as an inhibitor of viral RNA synthesis. Peginterferon with or without sofosbuvir is no longer recommended in an initial HCV treatment. [14][15], Sofosbuvir is also used with other medications and longer treatment durations, depending on specific circumstances, genotype and cost-effectiveness–based perspective. Each has been given a "run rate" of how many people they are allowed to treat, which was the NHS' single biggest new treatment investment in 2016. [8][5][11] It is on the World Health Organization's List of Essential Medicines. It is metabolized to the active antiviral agent GS-461203 (2'-deoxy-2'-α-fluoro-β-C-methyluridine-5'-triphosphate). The government in turn made it free to people. All Rights Reserved, {{app['fromLang']['value']}} -> {{app['toLang']['value']}}, Pronunciation of crassulacean with 4 audio pronunciations, Audio Pronunciation removed from collection. Here are 4 tips that should help you perfect your pronunciation of 'metabolite':. We recommend you to try Safari. [42][43], In Germany negotiations between Gilead and health insurers led to a price of €41,000 for 12 weeks of treatment. You've got the pronunciation of crassulacean right. How to say metabolism. [22] It is recommended that sofosbuvir/ribarivin combinations be avoided in pregnant females and their male sexual partners in order to reduce harmful fetal defects caused by ribavirin. For example, fatigue and headache are nearly cut in half, influenza-like symptoms are reduced to 3–6% as compared to 16–18%, and neutropenia is almost absent in interferon-free treatment. Listen to the audio pronunciation in the Cambridge English Dictionary. Please [8], The interaction between sofosbuvir and a number of other drugs, such as ciclosporin, darunavir/ritonavir, efavirenz, emtricitabine, methadone, raltegravir, rilpivirine, tacrolimus, or tenofovir disoproxil, were evaluated in clinical trials and no dose adjustment is needed for any of these drugs. Crowdsourced audio pronunciation dictionary for 89 languages, with meanings, synonyms, sentence usages, translations and much more. [7] Safety during pregnancy is unclear; some of the medications used in combination may result in harm to the baby.