Darunavir/Cobicistat + Daclatasvir = Precautionary

Effect on Concentration

Darunavir/Cobicistat
No change
Applies within class?
No
Daclatasvir
Increase
Applies within class?
No

Pharmacologic Effects

Darunavir/Cobicistat
Effect
N/A
Applies within class?
No
Daclatasvir
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 13-Jul-2018

Summary

The pharmacokinetic data support coadministration of daclatasvir with atazanavir/ritonavir, efavirenz and/or tenofovir. Dosing recommendations with boosted protease inhibitors recommend that the dose of daclatasvir be reduced to 30 mg daily.

Sources

Darunavir/Cobicistat vs Daclatasvir ^

Study Design

This combination has not been studied, but given what is known about the metabolic and transport pathways of both of these agents, an interaction is not expected.

Study Results

When used as part of an antiretroviral regimen, in patients who are coinfected with HCV and HIV, zidovudine exposures are not expected to change in the presence of daclatasvir. Similarly, daclatasvir concentration is not expected to be altered due to zidovudine.

Study Conclusions

Manufacturer states that an interaction with NRTIs or Entry Inhibitors is not expected and a dose adjustment is not required for either agent. Given the role of other agents in the antiretroviral regimen, daclatasvir concentrations may be altered. Please see other drugs for individual interaction potential.

References

Bifano M, Howang C, Oosterhuis B, Hartstra J, Grasela D, Tiessen R, Bertz R. Assessment of pharmacokinetic interactions of the hcv ns5a replication complex inhibitor daclatasvir with antiretroviral agents: ritonavir-boosted atazanavir, efavirenz and tenofovir. Antiviral Therapy. 2013; 7: 931-940.