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Hepatologytextbook.com
Hepatology 2013
Chapter 12: Standard Therapy of Chronic Hepatitis C Virus Infection
By Markus Cornberg, Benjamin Maasoumy, Svenja Hardtke, Kerstin Port, Michael P. Manns, Heiner
Table 11. Overview of drug interactions of HCV-PIs with frequently used co-medications.
Drug class
Suspected Effect of Co-
Recommendation for
Alternatives without
administration
Management
interactions
Analgesics
Acetylsalicylic acid
Buprenorphine
Ibuprofen
Morphine
Paracetamol Pethidine
monitoring Dose adjustments may be needed
Antiarrhytmics
Atenolol
Metoprolol
close/cautious monitoring (amiodarone drug levels); Should be avoided
carefully titrated, starting with the lowest dosage. Close/cautious monitoring
BOC: Very close/cautious monitoring (Quinidine drug levels); Should be avoided
TLV: Contraindicated BOC: Should be avoided
Antibiotics
Aminoglycosides
Azithromycin
Ciprofloxacin
Linezolid
Meropenem
Moxifloxacin
Rifaximin
Streptomycin
Trimethoprim/
Sulfamethoxazole
Vancomycin
Anticoagulants
Anticonvulsants
Gabapentin
Lamotrigine
Levetiracetam
Valproate
levels May alter phenobarbital levels (TLV)
Antidepressants
Clomipramine
Fluvoxamine
Imipramine
Nortriptyline
monitoring Dose adjustments may be needed
monitoring Dose adjustments may be needed
Antifungals
Amphotericin B
Flucytosine
Daily dose of itraconazole should not exceed 200mg/d
ECG) Daily dose of ketoconazole should not exceed 200mg/d
Antihypertensiv
Atenolol
Furosemide
Losartan
Metoprolol
Nebivolol
Ramipril
Spironolacton
Antimigraine
Rizatriptan
Antiprotozoals
Atovaquone
Pyrimethamine
Antipsychotics/
Olanzapine
Neuroleptics
Anxiolytics/
Lorazepam
Hypnotics/
Oxazepam
Sedatives
Parenteral: Very close monitoring; lower dosage (50%); Should be avoided
Erectile
Dysfunction
dose must not exceed 25 mg every 48 hours; TLV: Should be avoided
monitoring; vardenafil dose must not exceed 2.5 mg every 24 hours; TLV: Should be avoided
Gastrointestinal
Esomeprazole
Omeprazole
Pantoprazole
Azathioprine
suppressants
Dose adjustments needed; Very close/cautious monitoring
Statines
Use statin with least
interaction (Pravastatin)
recommended; Daily dose must not exceed of 40mg; TLV: Contraindicated
Steroids
Beclometasone
adjustments; Very close/cautious monitoring; Should be avoided
not reliable. Use two effective non-hormonal methods.
Tamsulosin
May increase
Closer/cautious
tamsulosin levels
monitoring
Increased levels = increased cmax and/or prolonged time for elimination (AUC) References: EMA. Incivo; Summary of product characteristics. 2012:
Source: http://hepatologytextbook.com/Table12_11.pdf
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