Hepatitis Drugs Charts First Line Agents for Genotypes 1-3 PDF

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Summary

Dr. Khorassani Hepatitis Drug Charts ...

Description

First Line Agents for Genotypes 1-3 MOA Harvoni

HCV nucleotide analog NS5A/B polymerase inhib

Dosing 1 tablet QD

Genotypes

Adverse Effects

Drug Interactions

Special Populations

1, 2, 3, 4

- Fatigue - Headache - N/V - Insomnia

- PPIs and H2RAs reduce absorption of ledipasvir - Avoid strong p-gp inhibitors

- Indicated for decompensated cirrhosis in combo w/ribavirin - Most commonly used

*Avoid CrCl < 30 ml/min Zepatier

NS5A inhib (elbasvir) and NS3/4A protease inhibitor (grazoprevir)

1 tablet QD

1, 4

- Fatigue - Headache

- Moderate CYP3A induces - Strong 3A4 inhibitors

- Approved for use in pts with renal impairment - CI w/decompensated cirrhosis

Epclusa

NS5A inhibitor (velpatasvir) and NS5b inhibitor (sofosbuvir)

1 tablet QD +/ribavirin w/ or w/o food

All genotypes (1-6)

- Fatigue - Headache

- Use w/ P-gp inducers and/or mod to potent CYP inducers - Coadmin of amiodarone

- Indicated for decompensated cirrhosis in combo w/ Ribavirin

Mavyret

NS3/4A + NS5A inhibitors

3 tablets QD

All genotypes (1-6)

- Fatigue - Headache - GI upset

- Carbamazepine and efavirenz may dec concentrations - Coadmin w/ warfarin necessitates more frequent INR monitoring

- CI w/ decompensated cirrhosis - Approved for use in pts w/ renal impairment

Harvoni & Epclusa: Decompensated cirrhosis w/ Ribavirin Zepatier & Mavyret: CI with decompensated cirrhosis, Can use in renal impairment Epclusa & Mavyret: All genotypes

ALT TX

MOA

Dosing

Genotypes

AE

Drug Interactions

Special Populations

Simeprevir + Sofosbuvir

1

- Nausea - Fatigue - Dizziness - Myalgia - Dyspnea

- moderate-strong CYP inhibitors/inducers

- Not indicated for decompensated cirrhosis

1 tab QD with food

1-6

- Nausea - Fatigue - Headache - Diarrhea

- Pgp and strong CYP inducers will decrease Vosevi concentration - Monitor INR

- Indicated for pts with prior tx w/ a NS5A inhibitor - CI w/ decompensated cirrhosis

1 tab QD w/ or w/o food

1, 2, 3

- Fatigue - Headache

- CI w/ strong 3A inducers - Dose adjustment req w/ many other drugs (certain antiretrovirals, dabigatran, moderate and strong CYP 3A inhibitors, moderate CYP 3A inducers)

- Indicted for decompensated cirrhosis in combo w/ Ribavirin

- 2 tab of Ombitasvir/ Paritaprevir/ Ritonavir Q AM - 1 tab of dasabuvir BID

1

- Fatigue - Headache - Pruritus - Asthenia

- Highly metabolized by 3A4 - Strong inducers of CYP3A/2C8 - Strong CYP2C8 inhibitors - Ethinyl estradiol contain PO contraceptive

- Caution in HCV/HIV1 coinfected pts - risk of protease inhib resistance - CI decompensated cirrhosis - CI severe hepatic impairment

4

- Fatigue - Headache - Insomnia - Asthenia

- Mod/Strong CYP3A inducers - Drugs highly dependent on 3A for clearance

- CI decompensated cirrhosis - Not commonly used (genotype 4)

HCV nucleotide analog NS3/4A protease inhibitor + NS5B polymerase inhibitor

1 tab (150 mg) simeprevir + 1 tab (400 mg) sofosbuvir QD

Vosevi

NS5A/B polymerase inhibitor, NS3/4A protease inhibitor

Daclinza

NS5A/B polymerase inhibitor

*Avoid CrCl...