Daclatasvir + Posaconazole = Precautionary

Effect on Concentration

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

Pharmacologic Effects

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

Interaction History

N/A

Last Updated 09-Jul-2018

Summary

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

Sources

Daclatasvir vs Posaconazole ^

Study Design

*This interaction has not been formerly studied, but inferences are drawn from knowledge of the metabolic and transport pathways of each of the drugs.

Study Results

The manufacturer states that coadministration of daclatasvir with inhibitors or inducers of either CYP3A or P-gP may alter daclatasvir concentrations.

Study Conclusions

Inhibitors of P-gP or CYP3A may increase daclatasvir concentrations, while inducers of this enzyme and transport protein may decrease daclatasvir concentrations.

References

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