FAQs

  • Can I smoke tobacco while taking DAAs Open or Close

    Yes

    It’s not good for you and you should give up ASAP but nicotine as a drug will not intearct with the Direct Acting Antivirals like Harvoni.

  • Can I drink alcohol while taking DAAs? Open or Close

    Yes, you can.

    The usual too much alcohol is bad for you advice applies, but drinking alcohol will not adversely impact your treatment.

    Your GGT will probably remain elevated if you are drinking but that's the booze not the bug.

  • How should I store my Hepatitis C medications? Open or Close

    The original manufacturers of Sofosbuvir, Ledipasvir, Daclatasvir say this in their CMI:

    Keep HARVONI tablets in a cool, dry place where it stays below 30°C

    Store DAKLINZA tablets in a cool dry place where the temperature stays below 30°C.

    More or less all medications say something like this.

    For reference:

    • Sofosbuvir: Melting point. 95-100 ºC
    • Ledipasvir: Melting Point: 186 - 190ºC
    • Daclatasvir: Melting Point: 166-172°C

    So you could almost certainly store them at > 30 °C but if you follow the < 30 °C recommendations everything should be fine.

    The main issue with higher temperatures is that gelatine capsules will melt at 44 °C.

    The main issue with moisture is that both capsules and tablets are designed to fall apart in your stomach when they get wet.

    Refrigeration will be fine but does create moisture problems. While a fridge is cool and dry the problem occurs when you have warm moist air (room air) and then cool it causing the moisture to condense - you have probably seen this if you put hot food in the fridge with droplets of moisture rapidly replacing the steam on the lid.

    You should not freeze the medication although it won't hurt because freezing increases the molecular stability of the APIs, and in fact the NMI certificates found here http://fixhepc.com/blog/item/16-testing-provisions-patient-safety.html state:

    Recommended storage

    When not in use, this material should be stored at or below 4 ºC in a closed container in a dry, dark area. 

  • What are generic DAAs (Direct Acting Antivirals)? Open or Close

    DAAs are Direct Acting Antivirals and include Sofosbuvir, Daclatasvir and Ledipasvir.

    They cure Hepatitis C by directly interfering with viral replication and as a result are highly targeted with minimal side effects.

  • How do I take these generic DAAs? Open or Close

    You take them by mouth once a day.

    They are fast release medications that can be taken with or without food, in the morning or night. Many patients prefer night time as any dose associated side effects occur while sleeping.

    You just need the chemicals so the packaging does not matter. Raw powder, capsules or tablets will all work provided you take the appropriate daily dose of Sofosbuvir 400 mg, Ledipasvir 90 mg or Daclatasvir 60 mg.

    We have observed that in some small patients ~ 50 kg Daclatasvir at a dose of 60 mg can cause noticeable side effect that disappear at a slightly lower (~ 45 mg) dose. This makes some theoretical sense given a 50 kg person is only 2/3 the weight of an average 75 kg person.

    Normally no dose adjustment is required and the trials were done at the numbers stated (except for Daclatasvir which is sometimes reduced to 30 mg dose due to CYP3A4 inhibitor medication that a patient also needs to take).

  • What medications can I take with these generic DAAs? Open or Close

    You should not take Amiodarone because it can cause a very slow heart rate while taking DAAs.

    You should read the CMI and check for medication interactions here.

    In terms of routine medications:

    You can take routine painkillers: Aspirin, Paracetamol and Ibuprofen.

    You can take narcotic painkillers: Methadone, Morphine and Tramadol.

    You can take antimigraine treatment: Sumatriptan.

    You can take sedatives: Diazepam, Oxazepam, Temazepam, Zolpidem.

    You can take antibiortics: Amoxicillin, Cefalexin, Norfloxacin, Trimethoprim/Sulfamethoxazole

    For any medication not listed as safe above please use this interactions checker: http://www.hep-druginteractions.org/checker

    To use this tool

    1. Select your treatment medications and click next
    2. Select search by alphabetical list of drugs and click next again
    3. Select the medications(s) you are/want to take by ticking the box
    4. Click Finish

    If it is all green boxes don't worry.

    If you see an orange box click on it for details - typically it will say "not studied, expected to be safe" so don't worry.

    If it is red DO NOT TAKE THIS MEDICATION but if you are already taking it consult with a doctor for advice.

    You can generate a PDF with all the details.

  • What is CYP3A4? Open or Close

    CYP3A4 is a liver enzyme that metabolises many medications.

    It metabolises Daclatasvir and foods, medications and supplements that impact on the function (particularly inhibit) CYP3A4 should not be taken by patients taking Daclatasvir.

    You will find lists of CYP3A4 inhibitors here:

    https://liferaftgroup.org/long-list-of-inhibitors-and-inducers-of-cyp3a4-and-cyp2d6/

    http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/DrugInteractionsLabeling/ucm093664.htm

  • What foods should I eat to help with Hepatitis C? Open or Close

    You should eat a normal varied diet.

    On Daclatasvir you should not eat Grapefruit as it can cause the levels of the medication to rise due to its inhibition of CYP3A4. You should not take medications, food or supplements that inhibit CYP3A4.

  • What supplements can I take? Open or Close

    Your body does not typically need supplements. A normal diet consisting of a variety of foods is sufficient.

    While most supplements will be harmless, and will not interact with your medications, they have not been studied, so we recommend you do not take them during treatment.

    If you insist, take them at the opposite end of the day to the time you take your medication.

    Please use the drug interaction checker here to check anything you are taking, or plan to take will not interact with your treatment.

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