Drug–drug interactions are a potential issue for all IFN-free treatment regimens. Important drugs to consider for potential interactions with DAAs include proton pump inhibitors, statins, St John’s wort, antimicrobials, anti-epileptic agents, amiodarone, immunosuppressive agents including cyclophilin inhibitors and mammalian target of rapamycin (mTOR) inhibitors, and antiretroviral agents.
Notably, the combination of sofosbuvir with a second DAA for the treatment of HCV is contraindicated with concomitant use of amiodarone due to the risk of severe symptomatic bradycardia. It is strongly recommended that concomitant medications be reviewed before starting treatment for any person, using the University of Liverpool’s Hepatitis Drug Interactions website.
We recommend working with an experienced pharmacist to confirm the safety of concomitant medications before starting DAA regimens. Patients should be advised to seek advice before starting any new medication during DAA therapy.