HepC Meds

Question 1

Ribavirin Safety SE and Monitoring

Answer 1

Significant teratogenic effects! Avoid pregnancy during therapy and for 6 MONTHS after
Hemolytic anemia is primary toxicity

Question 2

Ribavirin DDI

Answer 2

Do not use with didanosine due to risk of hepatic failure, peripheral neuropathy and pancreatitis
can increase hepatotoxic effects of all NRTIs
Zidovudine can enhance anemia effects of ribavirin

Question 3

Ribavirin indication

Answer 3

Indicated for HCV in COMBINATION with interferon alfa, simeprevir, and or sofosbuvir

Question 4

Protease Inhibitors

Answer 4

Boceprevir (Victrelis)

Simeprevir (Olysio)

Question 5

Sofosbuvir MOA and Indication

Answer 5

HCV NS5B RNA polymerase inhibitor. sofosbuvir is a nucleotide prodrug indicated for HepC ONLY with activity against HCV genotypes 1 through 4

Question 6

Sovaldi

Answer 6

Sofosbuvir

Question 7

Harvoni

Answer 7

Ledipasvir/sofosbuvir

Note: indicated for HCV genotype 1 ONLY

Question 8

Protease Inhibitor Indications

Answer 8

Indicated for the treatment of HCV genotype 1 infection in combination with peg interferon alfa and ribavirin

Question 9

Boceprevir Safety SE and Monitoring

Answer 9

Pregnancy warnings apply since they are to be used in combo with peg and ribavirin
Boceprevir - fatigue, chills, anemia (requiring ESA use), neutropenia, dysgeusia (metallic taste), NVD, HA, chills
Never reduce the dose or interrupt therapy as treatment failure may result. Never use as mono therapy. Must always be in combo with peg interferon AND ribavirin

Question 10

Simeprevir Safety SE and Monitoring

Answer 10

Pregnancy warnings apply since they are to be used in combo with peg and ribavirin
SE include rash, pruritus, myalgia, dyspnea

Question 11

Protease Inhibitors DDI

Answer 11

Beceprevir is a STRONG CYP3A4 inhibitor and a 3A4 substrate as well as a Pgp inhibitor
Simeprevir is a mild 1A2 inhibitor and intestinal 3A4 inhibitor but it DOES NOT affect hepatic 3A4 activity
Simeprevir is a 3A4 substrate do so not administer with moderate or strong 3A4 inhibit or inducers