PK of Direct Acting Antivirals (DAA) of HCV Flashcards
What is the generic name of Harvoni?
Sofosbuvir/ledipasvir
What is the generic name of Epclusa?
Sofosbuvir/velpatasvir
What is the generic name of Vosevi?
Sofosbuvir/velpatasvir/voxilapravir
What is the generic name of Mavyret?
Glecaprevir/pibrentasvir
What is the generic name of Zepatier?
Elbasvir/grazoprevir
Name the generic drug(s) that are NS5A inhibitors [Hint: think of names that have an ‘a’ towards the end]
Ledipasvir
Velpatasvir
Pibrentasvir
Elbasvir
Name the generic drug(s) that are NS5B nucleotide polymerase inhibitors [Hint: think of names that have a ‘b’ towards the end]
Sofosbuvir
Name the generic drug(s) that are NS3/4A protease inhibitors [Hint: think of previr at the end of the name]
Voxillaprevir
Glecaprevir
Grazoprevir
Which medication is the only anti-viral for HCV taken 3 times a day?
Glecapravir/pibrentasvir (Mavyret)
How long does it take for all DAAs to be absorbed (generally)?
About 3 hours
(T/F) - ALL DAA for HCV have to be taken without food
FALSE - DAA for HCV can be taken with or without food
Which drug(s) is/are renally eliminated? & how much?
Sofosbuvir - 80%
Which drug(s) is/are biliary/feces eliminated?
Ledipasvir Velpatasvir Pivrentasvir Glecaprevir Voxillaprevir
Which drug(s) is/are predominately removed by feces and minimal by the kidneys?
Elbasvir and grazopravir
In which combined medications are rifampin contraindicated with?
Vosevi, Mavyret, and Zepatier
Remember all protease inhibitors
Which DRUGS are contraindicated with rifampin?
NS3/4A Protease Inhibitors
- Voxilaprevir
- Glecaprevir
- Grazoprevir
In which medications is St. John’s Wort (P-gp inducer) not recommended or contraindicated? Why?
ALL OF THEM; will reduce the meds concentration
Which anticonvulsants are not recommended in Harvoni, Epclusa, and Vosevi?
Carbamazepine
Phenytoin
Phenobarbital
Oxcarbazepine
Which antiarrhythmic drug is not recommended in Harvoni, Epclusa, and Vosevi? Why not?
Amiodarone; bradycardia can occur
Carbamazepine and phenytoin (only these two) are CONTRAINDICATED in which medication?
Zepatier (elbasvir and grazoprevir)
What is the only medication NOT RECOMMENDED with nafcillin (CYP3A inducer)? Why?
Zepatier (elbasvir and grazoprevir); concentration of zepatier will decrease
Which medication is not recommended with rosuvastatin?
Harvoni (sofosbuvir and ledipasvir)
Which 3 medications is antacids not recommended to be used simultaneously? How can it be avoided?
Harvoni (sofosbuvir and ledipasvir)
Epclusa (sofosbuvir and velpatasvir)
Vosevi (sofosbuvir, velpatasvir, and voxilaprevir)
Separate antacids by 4 hours
Can H2 blockers (famotidine) be taken with Harvoni, Epclusa, and Vosevi?
Yes, but just the max of 40 mg BID
Can PPI blockers (omeprazole) be taken with Harvoni, Epclusa, and Vosevi?
Yes, but just the max of 20 mg QD
Can antacids, H2 blockers, and PPI inhibitors be taken with Zepatier and Mavyret?
YES; no interactions
Which 4 medications increase the concentration of digoxin?
Harvoni (sofosbuvir and ledipasvir)
Epclusa (sofosbuvir and velpatasvir)
Vosevi (sofosbuvir, velpatasvir, and voxilaprevir)
Mavyret (glecaprevir and pibrentasvir)
Which medication does not affect digoxin levels?
Zepatier (elbasvir and grazoprevir)
Can Harvoni be taken simultaneously with rosuvastatin?
NO
Can Harvoni be taken with other statins?
YES
Can Epclusa, Vosevi, Mavyret, and Zepatier be taken with rosuvastatin?
YES
What is the max dose that rosuvastatin can be taken as?
10 mg QD
Can pravastain be taken with all of the HCV medications?
YES
What is the max does pravastatin can be taken as?
40 mg QD
Which 2 medications is cyclosporine not recommended with?
Vosevi (sofosbuvir, veltapasvir, voxilaprevir)
Mavyret (pibrentasvir and glecaprevir)
Which medication is cyclosporine contraindicated with?
Zepatier (elbasvir and grazoprevir)
Which medication should tacrolimus be monitored closely with?
Zepatier (elbasvir and grazoprevir)
