Indications
Daclatasvir is an antiviral medicine used together with Sofosbuvir (and sometimes Ribavirin) to treat long term (chronic) hepatitis C virus infection in adults. It is never used on its own. It works against several hepatitis C genotypes, especially genotype 1 and 3.
How It Works
The hepatitis C virus needs a protein called NS5A to copy itself and build new virus particles. Daclatasvir blocks NS5A. When combined with Sofosbuvir, which blocks a different viral enzyme, the virus cannot multiply and is cleared from the blood in most people, which means the infection is cured.
Dosage and Administration
The usual adult dose is 60 mg once a day by mouth, with or without food, together with Sofosbuvir, for 12 weeks (sometimes 24 weeks, for example in people with cirrhosis). The dose may be lowered to 30 mg or raised to 90 mg when taken with certain other medicines; your doctor will decide. Take it at the same time each day and complete the full course even if you feel well.
Interactions
- Amiodarone taken with Daclatasvir and Sofosbuvir can cause a dangerously slow heartbeat; this combination should be avoided.
- Strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s Wort must not be used with it, as they stop it working.
- Strong CYP3A4 blockers such as Clarithromycin, Itraconazole and some HIV medicines require a lower dose (30 mg).
- Some HIV medicines such as Efavirenz may require a higher dose (90 mg).
- It may raise levels of Digoxin, Dabigatran and some statins.
Contraindications
- Allergy to Daclatasvir.
- Use with strong CYP3A4 inducers such as Rifampicin, Carbamazepine, Phenytoin or St John’s Wort.
Side Effects
Common side effects, mostly from the combination treatment, include tiredness, headache, nausea, trouble sleeping, dizziness and diarrhoea. If Ribavirin is also used, anaemia (low blood count) is common. In people who also carry hepatitis B, the hepatitis B infection can flare up during or after treatment.
Get urgent medical help if you notice a very slow heartbeat, fainting, chest pain or breathlessness (especially if you take Amiodarone), yellowing of the skin or eyes, dark urine, or signs of a serious allergic reaction.
Pregnancy and Lactation
There is not enough information on use in pregnancy, so it should be avoided unless a doctor decides it is necessary. If Ribavirin is part of the treatment, pregnancy must be strictly avoided by both female patients and female partners of male patients during and for months after treatment. Breastfeeding is not recommended during treatment.
Precautions and Warnings
- You will be tested for hepatitis B before treatment.
- Tell your doctor about all medicines and herbal products, as interactions are common.
- Blood tests will check the response to treatment.
- A cure does not protect against getting hepatitis C again; avoid sharing needles, razors and toothbrushes.
Overdose
There is limited experience of overdose. If too much is taken, contact a doctor or hospital. Treatment is supportive with monitoring.
Therapeutic Class
Direct acting antiviral for hepatitis C; NS5A inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.