Daclatasvir
Mechanism :
Daclatasvir binds to the N-terminus within Domain 1 of HCV non-structural protein 5A (NS5A) and inhibits viral RNA replication and virion assembly.
Indication :
- Treatment of chronic hepatitis C virus (HCV) genotype 1 or genotype 3 infection in combination with sofosbuvir, with or without ribavirin
- Chronic hepatitis C (genotype 2); Chronic hepatitis C (genotype 4); Chronic hepatitis C (genotype 5 or 6)
Contraindications :
Hypersensitivity to daclatasvir or any component of the formulation; concurrent use with strong inducers of CYP3A4 and P-glycoprotein (P-gp).
Dosing :
<18 years:
Safety and efficacy not established.
Adults:
Genotype 1, 3 and 4:
60 mg PO OD x 12 weeks. For genotype 2 can give for 16-24 weeks.
Adverse Effect :
Headache, Fatigue, Nausea, Diarrhea, Elevated lipase.
Interaction :
Amiodarone: Daclatasvir may enhance the bradycardic effect of Amiodarone.
CYP3A4 Inducers: May decrease the serum concentration of Daclatasvir.
CYP3A4 Inhibitors: May increase the serum concentration of Daclatasvir.
P-glycoprotein/ABCB1 Substrates: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of P-glycoprotein/ABCB1 Substrates.
Warfarin: Daclatasvir may enhance the anticoagulant effect of Warfarin.
Hepatic Dose :
No dosage adjustments are recommended.