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.

You take them by mouth once a day.

They are fast release medications (so can be crushed) and 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. This is probably the best time for generic Harvoni® and generic Epclusa® as stomach acid helps absorbtion and is maximal in the early hours of the morning.

About 1 in 5 patients gets headaches when taking sofosbuvir based medication. These usually settle after the first week. Extra fluid intake (about 1 litre) and ordinary headache tablets like aspirin, paracetamol and ibuprofen all work well and do not interact.

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.

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

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.

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.