Daclatasvir + Voriconazole = Precautionary

Effect on Concentration

Daclatasvir
Increase
Applies within class?
No
Voriconazole
No change
Applies within class?
No

Pharmacologic Effects

Daclatasvir
Effect
N/A
Applies within class?
No
Voriconazole
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 09-Jul-2018

Summary

Sources

A review of daclatasvir drug–drug interactions ^

Study Design

Caution is warranted when utilizing this combination since this interaction has not been studied at this time. The drug-drug interaction potential of daclatasvir (DCV) with ketoconazole was assessed. Ketoconazole was given as 400mg QD while DCV was administered as a single dose of 10mg.

Study Results

The geometric mean ratios (GMR) and corresponding 90% confidence intervals (90% CI), of the Cmax and AUC for daclatasvir was 1.57 (1.31-1.88) and 3.00 (2.62-3.44), respectively. *The effect on ketoconazole was not reported

Study Conclusions

The manufacturer recommends reducing the dose of DCV to 30mg QD when this combination is utilized, due to strong CYP3A4 inhibition by voriconazole and ketoconazole. Monitoring is warranted due to the wide CIs for the Cmax and AUC.

References

Garimella T, You X, Wang R, Huang SP, Kandoussi H, Bifano M, Eley T. A review of daclatasvir drug–drug interactions. Advances In Therapy. 2016; 11: 1867-1884.