↑ levels and risk of toxicity with digoxin; ↓ dose of digoxin.
↑ levels and risk of adverse reactions including myopathy with HMG-CoA reductase inhibitors; closely monitor and ↓ dose of HMG-CoA reductase inhibitor if necessary).
May cause fluctuations in INR when used with warfarin; closely monitor INR.
Concurrent use of St. John's wort ↓ levels and effectiveness; concurrent use contraindicated.
PO (Adults) Genotype 1 (without cirrhosis or with compensated cirrhosis [Child-Pugh A])–60 mg once daily with sofosbuvir for 12 wk; Genotype 1 (with decompensated cirrhosis [Child-Pugh B or C] or post-liver transplant)–60 mg once daily with sofosbuvir and ribavirin for 12 wk; Genotype 3 (without cirrhosis)–60 mg once daily with sofosbuvir for 12 wk; Genotype 3 (with compensated cirrhosis [Child-Pugh A], decompensated cirrhosis [Child-Pugh B or C], or post-liver transplant)–60 mg once daily with sofosbuvir and ribavirin for 12 wk; Concurrent use of strong CYP3A inhibitors–30 mg once daily; Concurrent use of moderate CYP3A inducers or nevirapine–90 mg once daily.
Tablets: 30 mg, 60 mg
Monitor for signs and symptoms of chronic hepatitis C.
Monitor for clinical and laboratory signs of hepatitis flare or HBV reactivation during therapy and post-treatment follow-up in patients with serologic evidence of HBV infection. Initiate therapy for HBV infection as indicated.
Lab Test Considerations:
Test all patients for current or prior hepatitis B virus (HBV) infection by measuring hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) before starting therapy. Monitor for HBV reactivation during and following therapy.
Obtain NS5A resistance testing in patients with HCV genotype 1a and cirrhosis prior to starting therapy.
Must be administered in conjunction with sofosbuvir. If sofosbuvir is permanently discontinued, daclatasvir must also be discontinued.
PO Administer once daily without regard to food for 12 wk.
Instruct patient to take daclatasvir with sofosbuvir as directed. Take missed dose as soon as remembered in same day. If not until next day, skip dose and take next dose as scheduled; do not double doses. Advise patient to read Patient Information for each medication before starting therapy and with each Rx refill in case of changes.
Advise patient receiving beta-blockers or having underlying significant cardiovascular/hepatic disease to notify health care professional if signs and symptoms of bradycardia (near-fainting or fainting, dizziness, malaise, weakness, excessive tiredness, shortness of breath, chest pain, confusion, memory problems) occur.
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially St. John's wort.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.
Decreased presence of HCV with decreased sequelae of HCV infection.
daclatasvir is a sample topic from the Davis's Drug Guide.
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