Brand Name : Myhep Dvir
Active components : Sofosbuvir, Daclatasvir
Strength of the components : 400mg & 60mg respectively
Manufactured by : Mylan Pharmaceuticals
Category :Anti-viral drug


Myhep Dvir tablets are hostile to viral medicine Myhep Dvir tablets are single measurements treatment, it is a doctor prescribed medication utilized by the patients just under the information of restorative expert who are all around rehearsed Daclatasvir isn't utilized alone, for better activity it ought to be joined with Sofosbuvir tablet. In some condition Myhep Dvir is joined with ribavirin, a hostile to viral pharmaceutical utilized as a part of decompensated (Child Pugh B or C) cirrhosis


The primary sign of Myhep Dvir is; This mix tablets are utilized to treat the constant hepatitis C viral disease caused by genotype I or III The significant restriction happened while utilizing Myhep Dvir tablets are lessening of steady virological reaction rate in hepatitis C genotype I or III contaminated patients.


The activity of Myhep Dvir tablets are occurred by involving in some mechanism;


Sofosbuvir containing sofosbuvir has hostile to hepaciviral movement, which is specifically acting medication displays its activity by disallowing NS5B RNA dependent RNA polymerase protein; fundamental for hepatitis viral duplication. Sofosbuvir is processed to frame uridine triphosphate, a fundamental dynamic metabolite which uncovered a hostile to viral action. The mixture of this dynamic metabolite into hepatitis viral RNA with the assistance of NS5B polymerase and causes viral chain cessation


Daclatasvir containing Daclatasvir removes hostile to viral action by restricting NS5A protein which is needful in viral generation and virion collection


Myhep Dvir tablets are given with or without food, in the condition of chronic hepatitis C viral infection originated by genotype I or III Myhep Dvir is single dose therapy

Dosage regimens

Daclatasvir normally is not used alone treatment, it is combined with Sofosbuvir The suggested dosage of Myhep Dvir is one tablet should be taken as a single dose If Sofosbuvir is discontinued, Daclatasvir also get stopped Genotype I Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Myhep Dvir is one tablet should be taken as a single dose with or without food In decompensated cirrhosis patients: Myhep Dvir should be altogether with ribavirin as a single dose

Genotype III

Patient suffered without cirrhosis or with compensated cirrhosis: The recommended usual dosage of Myhep Dvir is one tablet should be administered as a single dose with or without food In decompensated cirrhosis patients: Myhep Dvir should be concomitant with ribavirin as a once a day The dosage of ribavirin; The hemoglobin level of patients, dose can be calculated on basis of body weight. Below 75kg: The dosage is 1000mg of ribavirin; suggested for genotype I or III 600mg of ribavirin as an primary dose and followed as 1000mg/per Slightly 75 kg: The dose of 1200mg of ribavirin administrated In decompensated cirrhosis given as twice daily. The safety and efficacy of Daclatasvir has not been established <18 years Sofosbuvir used in ≥12 years or weight of ≥35kg


Absorption : The maximum plasma concentration of Daclatasvir tablets occurs within 2 hours The mean bioavailability of Daclatasvir is 67% The maximum plasma concentration of Sofosbuvir tablets occurs within the range of 0.5 to 2 hours relatively. The nourishment won't makes any variety in retention of Myhep Dvir tablets, might be taken with or without sustenance
Distribution :
Volume of distribution in Daclatasvir tablet is 47L Daclatasvir bounds to human plasma protein nearly 99% Blood to plasma ratio of Sofosbuvir is relatively 0.7 The Sofosbuvir bounds to human plasma protein nearly 61 to 65%
Metabolism :
Sofosbuvir metabolized in liver and formed as dynamic metabolite uridine triphosphate, metabolism experienced with the assistance of cathepsin A or carboxylesterase 1 Daclatasvir digestion happened with the assistance of CYP3A4
Elimination :
Nearly 88% of Daclatasvir is eliminated via feces; 53% as parent form; 6.6% eliminated through urine. Sofosbuvir metabolites are excreted through 80% in urine, 14% in feces & 2.5% in exhaled air The terminal half life period of Sofosbuvir is reaches at 0.51 hours; Daclatasvir half life period is 12 to 15 hours


While consolidating Myhep Dvir with solid CYP3A inducers causes loss of virological response rate of Daclatasvir CYP3A solid inducers like st Johns wort, rifampin, phenytoin or carbamazepine In the event that Sofosbuvir joins with P-gp or BCRP inhibitors prompts cause rise of Sofosbuvir plasma focus. Myhep Dvir tablets attendant with amiodarone causes genuine symptomatic bradycardia. Myhep Dvir tablets attendant with hostile to convulsants, against mycobacterials or natural items like st Johns wort causes diminish as a result of fixation Myhep Dvir with HMG CoA reductase inhibitors, this mix prompts because expanding the presentation of these medications (statins)

Dosage adjustment in drug interaction

If concurrent use with strong CYP3A inhibitors, the dosage of Daclatasvir is reduced to 30mg while co administration Concurrent use with moderate CYP3A inducers, the dosage of Daclatasvir increased to 90mg Concomitant use of Daclatasvir with CYP3A strong inducers should be avoided, it is contraindicated


A few contraindications happens while utilizing Myhep Dvir tablets In decompensated cirrhosis, joins with ribavirin contraindicated in pregnancy condition Some anaphylactic response happens if patients are contraindicated to the segments show in Myhep Dvir


Both Myhep Dvir tablets are single dosage treatment, if tolerant neglects to take the measurement of these tablets, must counsel the doctor and take the measurement inside the time according to the direction given by therapeutic expert Generally the missed measurement ought to be skipped and take after the standard dosing plan


While taking Myhep Dvir tablets, with CYP3A solid inducers causes loss of remedial reaction of Myhep Dvir tablets. Stay away from this accompanying to diminish the unfriendly impacts Myhep Dvir causes genuine bradycardia while simultaneous use with amiodarone, to keep this condition some elective solution is given or ends the amiodarone if conceivable. Insight the patients about the introduction of bradycardia amid the treatment Utilizing Myhep Dvir with ribavirin, ought not be prescribed in pregnancy condition as a result of creating fetal harm because of ribavirin


The most common side effects occurred during the therapy;
Headache, Loss of appetite, Irritability, Neutropenia, Anemia, Chills, Influenza like symptoms, Pyrexia, Myalgia, Pancytopenia, Fatigue, Nausea, Diarrhea, Elevation of lipase, Cardiac problems like symptomatic bradycardia , Insomnia, Pruritus, Asthenia, Rashes, on the grounds that almost 99% of medication limited to human plasma protein .


The over dose of Myhep Dvir tablets are happened because of missed measurement , if once finished dose happens the patients must be observed oftentimes for support of harmfulness and give wellbeing measures Hemodialysis is a technique used to take out the part from body, sofosbuvir evacuates with partition coefficient of 54% though Daclatasvir is hazardous

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