Brand name : Hepcdac
Active substance : Daclatasvir
Strength : 60mg
Manufactured by : Cipla
Pack : 28 tablets in a container
Category : Anti-viral drug
Hepcdac is an anti-viral medication which is used for preventing the disease progression of hepatitis C viral infection by reduces the multiplication of virus in the body. Hepcdac is used by combining with other anti-virals for treating the HCV infection in chronic stage majorly in adults. Hepcdac is usually combined with Sofosbuvir, with or without ribavirin.
Hepcdac is belongs to class like;
HCV NS5A protein inhibitor
Hepcdac is a NS5A protein inhibitor, NS5A is a HCV non structural phosphoprotein that is responsible for replicating function of charge of viral RNA augmentation on endoplasmic reticulum membranes. Hepcdac has ability to merge to viral RNA. There are two pathway involved in the mechanism of Hepcdac; Cis acting function of basally phosphorylated NS5A is responsible for maintaining the HCV replication complex. HCV assembly & infectious particle formation is altered by Trans acting function of hyperphosphorylated NS5A. Hepcdac is used to confuse the hyperphosphorylated NS5A proteins thus concludes as interceding with activity of newly produced HCV. Hepcdac works as blockade of; Intercellular viral RNA synthesis Virion assembly/ secretion in-vivo
Before starting the treatment; Patient’s HBsAg & anti-HBc levels should be monitored. Hepatic function test should be performed.
Without cirrhosis or Compensated cirrhosis: One Hepcdac with sofosbuvir or 12 weeks. Decompensated cirrhosis: One Hepcdac with sofosbuvir combined with ribavirin for 12 weeks Post transplant: One Hepcdac + sofosbuvir combined with ribavirin for 12 weeks. Genotype III; Without cirrhosis: One Hepcdac tablet should be combined with sofosbuvir for 12 weeks. Compensated or decompensated cirrhosis: One Hepcdac with sofosbuvir combined with ribavirin for 12 weeks
WARNING & PRECAUTION
HBV reactivation :
In HBV/HCV co infected patients, HBV reoccurrence occurs after completion of HCV anti-viral agents but not getting the HBV anti-viral agents. This fatal case causes hepatic failure & finally leads to death. Overcome the problem by measuring HBsAg & anti-HBc before starting the treatment. Initiate the patient management for HBV infection. Hepatic function test should be performed.
Increased exposure of loss of virological responses :
The concurrent use of Hepcdac with other drugs may leads to loss of therapeutic effect of Daclatasvir & possible advancement of resistance. Dosage modification should be involved during combinational treatment. The adverse reactions related to the concomitant use should be monitored.
Risk due to ribavirin :
The combination of Hepcdac & sofosbuvir with ribavirin should produce fetal harm during pregnancy period.
This lethal case should be occurred during the concomitant use of Hepcdac with amiodarone. This should be prevented by avoiding this combination. Monitor the ECG during the treatment. Initiate the alternative therapy for reducing the cardiac disorders. Counsel the patient before starting the treatment about the risk related to this combinational therapy.
Hepcdac combined with the strong inducers of CYP3A causes depletion of plasma evels of Daclatasvir which concludes as loss of therapeutic activity of Hepcdac. Hepcdac tablet combined with P-gp or BCRP substrates causes increased systemic exposure of these substrates & elevates the adverse effects related to this substrates. Hepcdac combined with warfarin causes bleeding effects by altering the prothrombin time & INR values. Hepcdac with protease inhibitors causes increased Daclatasvir effect of concentration, to prevent this problem by reducing the dose of Hepcdac to 30mg as once daily. Hepcdac combined with NNRTI, causes decreased Daclatasvir concentration, overcome the problem by increasing the dose of Hepcdac to 90mg. Hepcdac with strong CYP3A inhibitors causes increased Daclatasvir concentration. Hepcdac with moderate CYP3A inducers causes reduced concentration of Daclatasvir. Hepcdac with amiodarone causes serious bradycardia Hepcdac with lipid lowering drugs causes increased concentration of these drugs.
The combination of Hepcdac & sofosbuvir with ribavirin is contraindicated to pregnancy & lactating period. Hypersensitivity reactions are produced during the therapy while patients are contraindicated to component of Hepcdac.
Pregnancy category of Hepcdac is B Hepcdac with sofosbuvir pregnancy category is B Ribavirin pregnancy category is X Ribavirin should not be used in pregnancy condition.
No specific anti-toxin is required for treating the over dosage of Hepcdac. Patient should be provided with general supportive measures. The signs & symptoms of Hepcdac over dosage should be monitored. Hemodialysis should not be applicable; it is difficult to remove from the body because it is highly bounds to human plasma protein.
Missed DoseIf patients missed a dose then should be consult with medical practitioner & follow the instructions. On the other hand missed dose should be skipped. Avoid self medication Maintain the regular dosing schedule.
Breast feeding should not be suggested.
The safety & effectivity of Hepcdac in pediatric patients below 18 years should not be evaluated.
No dosage adjustment should be recommended
Chest pain or discomfort, Dizziness, Irregular heartbeat, Tiredness, Head ache , Nausea, Diarrhea, Insomnia, Dry skin, Influenza like syndrome, Dyspnea, Neutropenia, Pruritus, Thrombocytopenia, Bradycardia , Increased AST, ALT, Increased bilirubin, Hepatitis B reactivation .
RENAL & LIVER IMPAIRMENT
Dosage modification should not be recommended in both renal & hepatic impaired patients.
Store the container at temperature 25℃ (77℉). Keep the container away from moisture, heat & light.