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:
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BC PSLS CENTRAL OFFICE Volume 4 - ISSUE 2 - MAY 2010 Evolving BC PSLS as we grow! Message from Central Office BC PSLS continues to spread across the province as Vancouver Island Health Authority and Providence Health Care move forward with implementations over the coming months. At Health Authorities already using the system, the focus has shifted from rollout to ana