Dac and Led interactions

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29 December 2015 at 2:00 am #7475
dointime
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- Guardian Angel
@dointime
I have been looking at the prescribing information here:
http://fixhepc.com/forum/forum-gp-cheat-sheet.html

“Medications (Daclatasvir and Ledipasvir in particular have many interactions) you can check with this tool http://www.hep-druginteractions.org/checker

I checked with the tool and it is not showing any interactions for dac and led. It’s giving a green light.

So which is correct?
Thanks,
dt
29 December 2015 at 2:13 am #7476
dointime
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@dointime
Oh duh! I see that the prescribing info meant that both dac and led have many interactions with OTHER drugs.
I was thinking it meant they have many interactions with EACH OTHER.

Anyway, I am still unclear on the subject of whether dac and led have interactions with each other. I cannot find any information which suggests that they do. I also cannot find any evidence which proves that they don’t. I want to know if the concentration of either drug will be lowered by the presence of the other during a switchover from led to dac, while keeping sof the same?

Possibly this is still one of the many as yet unanswered questions about using the DAAs.

dt
29 December 2015 at 2:20 am #7477
dointime
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@dointime
PS
I meant to say “efficacy’, not “concentration” which may not be the same thing.
29 December 2015 at 2:43 am #7479
Gaj
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@gaj
I suspect there is little research on what you are asking as:

– It would require crosslabel trials which tend to be expensive.
– the standard treatment approach seems to be to use one NS5A inhibitor thoughout treatment and if that treatment fails to retreat preferably using another NS5A inhibitor that expresses itself via a different path if such an drug exists. This would apparently reduce any risk of resistance effecting the retreatment. I don’t know whether Dac and Led differ sufficiently to do that or whether they are entirely analogous.

I’m not a scientist just an interested reader so the above is just my take on it.

G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
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