Drug interactions between immunosuppressive agents and direct-acting antiviral agents for HCV infection

	Tacrolimus	Cyclosporine	Sirolimus	Everolimus	Azathioprine	Mycophenolate mofetil
Glecaprevir-pibrentasvir	Monitor levels^*	If cyclosporine dose >100 mg/day, not recommended	Monitor levels^¶	Monitor levels^Δ	✓	✓
Sofosbuvir-velpatasvir	Monitor levels^*	Monitor levels^◊	Monitor levels^¶	Monitor levels^Δ	✓	✓
Ledipasvir-sofosbuvir	Monitor levels^*	✓	Monitor levels^¶	Monitor levels^Δ	✓	✓
Sofosbuvir-velpatasvir-voxilaprevir	Monitor levels^*	Not recommended	Monitor levels^¶	Monitor levels^Δ	✓	✓
Sofosbuvir	Monitor levels^*	✓	✓	✓	✓	✓
Daclatasvir	Monitor levels^*	✓	Monitor levels^¶	Monitor levels^Δ	✓	✓

Overall, data informing the likelihood of drug interactions between direct-acting antivirals and immunosuppressive agents are limited. Most recommendations are based on expected pharmacokinetics.

The checkmark indicates no expected interactions that warrant change in management.

DAA: direct-acting antiviral; HCV: hepatitis C virus.

* Levels of tacrolimus may initially increase with concurrent administration, particularly with glecaprevir-pibrentasvir. Additionally, tacrolimus levels may decrease during DAA treatment related to changes in liver function with clearance of HCV. Tacrolimus levels should be followed, with dose adjustments as necessary.

¶ Levels of sirolimus may be increased with concurrent administration and should be followed, with dose adjustments as necessary.

Δ Levels of everolimus may be increased with concurrent administration and should be followed, with dose adjustments as necessary.

◊ Levels of cyclosporine may be affected with concurrent administration and should be followed, with dose adjustments as necessary.

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خرید پکیج

Drug interactions between immunosuppressive agents and direct-acting antiviral agents for HCV infection