PK of Direct Acting Antivirals (DAA) of HCV

Question 1

What is the generic name of Harvoni?

Answer 1

Sofosbuvir/ledipasvir

Question 2

What is the generic name of Epclusa?

Answer 2

Sofosbuvir/velpatasvir

Question 3

What is the generic name of Vosevi?

Answer 3

Sofosbuvir/velpatasvir/voxilapravir

Question 4

What is the generic name of Mavyret?

Answer 4

Glecaprevir/pibrentasvir

Question 5

What is the generic name of Zepatier?

Answer 5

Elbasvir/grazoprevir

Question 6

Name the generic drug(s) that are NS5A inhibitors [Hint: think of names that have an ‘a’ towards the end]

Answer 6

Ledipasvir
Velpatasvir
Pibrentasvir
Elbasvir

Question 7

Name the generic drug(s) that are NS5B nucleotide polymerase inhibitors [Hint: think of names that have a ‘b’ towards the end]

Answer 7

Sofosbuvir

Question 8

Name the generic drug(s) that are NS3/4A protease inhibitors [Hint: think of previr at the end of the name]

Answer 8

Voxillaprevir
Glecaprevir
Grazoprevir

Question 9

Which medication is the only anti-viral for HCV taken 3 times a day?

Answer 9

Glecapravir/pibrentasvir (Mavyret)

Question 10

How long does it take for all DAAs to be absorbed (generally)?

Answer 10

About 3 hours

Question 11

(T/F) - ALL DAA for HCV have to be taken without food

Answer 11

FALSE - DAA for HCV can be taken with or without food

Question 12

Which drug(s) is/are renally eliminated? & how much?

Answer 12

Sofosbuvir - 80%

Question 13

Which drug(s) is/are biliary/feces eliminated?

Answer 13

Ledipasvir
Velpatasvir
Pivrentasvir
Glecaprevir
Voxillaprevir

Question 14

Which drug(s) is/are predominately removed by feces and minimal by the kidneys?

Answer 14

Elbasvir and grazopravir

Question 15

In which combined medications are rifampin contraindicated with?

Answer 15

Vosevi, Mavyret, and Zepatier

Remember all protease inhibitors

Question 16

Which DRUGS are contraindicated with rifampin?

Answer 16

NS3/4A Protease Inhibitors

• Voxilaprevir
• Glecaprevir
• Grazoprevir

Question 17

In which medications is St. John’s Wort (P-gp inducer) not recommended or contraindicated? Why?

Answer 17

ALL OF THEM; will reduce the meds concentration

Question 18

Which anticonvulsants are not recommended in Harvoni, Epclusa, and Vosevi?

Answer 18

Carbamazepine
Phenytoin
Phenobarbital
Oxcarbazepine

Question 19

Which antiarrhythmic drug is not recommended in Harvoni, Epclusa, and Vosevi? Why not?

Answer 19

Amiodarone; bradycardia can occur

Question 20

Carbamazepine and phenytoin (only these two) are CONTRAINDICATED in which medication?

Answer 20

Zepatier (elbasvir and grazoprevir)

Question 21

What is the only medication NOT RECOMMENDED with nafcillin (CYP3A inducer)? Why?

Answer 21

Zepatier (elbasvir and grazoprevir); concentration of zepatier will decrease

Question 22

Which medication is not recommended with rosuvastatin?

Answer 22

Harvoni (sofosbuvir and ledipasvir)

Question 23

Which 3 medications is antacids not recommended to be used simultaneously? How can it be avoided?

Answer 23

Harvoni (sofosbuvir and ledipasvir)
Epclusa (sofosbuvir and velpatasvir)
Vosevi (sofosbuvir, velpatasvir, and voxilaprevir)
Separate antacids by 4 hours

Question 24

Can H2 blockers (famotidine) be taken with Harvoni, Epclusa, and Vosevi?

Answer 24

Yes, but just the max of 40 mg BID

Question 25

Can PPI blockers (omeprazole) be taken with Harvoni, Epclusa, and Vosevi?

Answer 25

Yes, but just the max of 20 mg QD

Question 26

Can antacids, H2 blockers, and PPI inhibitors be taken with Zepatier and Mavyret?

Answer 26

YES; no interactions

Question 27

Which 4 medications increase the concentration of digoxin?

Answer 27

Harvoni (sofosbuvir and ledipasvir) Epclusa (sofosbuvir and velpatasvir) Vosevi (sofosbuvir, velpatasvir, and voxilaprevir) Mavyret (glecaprevir and pibrentasvir)

Question 28

Which medication does not affect digoxin levels?

Answer 28

Zepatier (elbasvir and grazoprevir)

Question 29

Can Harvoni be taken simultaneously with rosuvastatin?

Answer 29

NO

Question 30

Can Harvoni be taken with other statins?

Answer 30

YES

Question 31

Can Epclusa, Vosevi, Mavyret, and Zepatier be taken with rosuvastatin?

Answer 31

YES

Question 32

What is the max dose that rosuvastatin can be taken as?

Answer 32

10 mg QD

Question 33

Can pravastain be taken with all of the HCV medications?

Answer 33

YES

Question 34

What is the max does pravastatin can be taken as?

Answer 34

40 mg QD

Question 35

Which 2 medications is cyclosporine not recommended with?

Answer 35

Vosevi (sofosbuvir, veltapasvir, voxilaprevir) | Mavyret (pibrentasvir and glecaprevir)

Question 36

Which medication is cyclosporine contraindicated with?

Answer 36

Zepatier (elbasvir and grazoprevir)

Question 37

Which medication should tacrolimus be monitored closely with?

Answer 37

Zepatier (elbasvir and grazoprevir)