Copyright ©The Author(s) 2015.
World J Hepatol. Feb 27, 2015; 7(2): 213-225
Published online Feb 27, 2015. doi: 10.4254/wjh.v7.i2.213
Table 1 Dosage modification for patients with renal impairment
Creatinine clearancePegylated-interferon alfa-2aPegylated-interferon alfa-2bRibavirin
30-50 mL/min180 μg/wk1.125 μg/kg per week (25% reduction)Alternating doses; 200 mg and 400 mg every other day
< 30 mL/min135 μg/wk (25%-45% reduction)0.75 μg/kg per week (50% reduction)200 mg/d
Hemodialysis135 μg/wk (25%-45% reduction)0.75 μg/kg per week (50% reduction)200 mg/d
Table 2 Pharmacokinetic and metabolic parameters of selected direct acting antivirals
DrugsMetabolism/excretion routeInteraction with CYP3AComments
NS3/4A protease inhibitors
BoceprevirHepatic (CYP3A, aldoketoreductase)Moderate CYP3A inhibitorSignificant DDI with other CYP3A substrate drugs
TelaprevirHepatic (CYP3A)Strong CYP3A inhibitorSignificant DDI with other CYP3A and P-gp substrate drugs
SimeprevirHepatic (CYP3A)Mild CYP1A2 and CYP3A inhibitorUnconjugated hyperbilirubinemia commonly seen
FaldaprevirHepatic (CYP3A)Moderate CYP3A inhibitor; weak CYP2C9 inhibitorInhibition of UGTA1 results in unconjugated hyperbilirubinemia
ABT-450/ ritonavirHepatic (CYP3A)Strong CYP3A inhibitor (by ritonavir)Unconjugated hyperbilirubinemia
NS5A replication complex inhibitors
DaclatasvirHepatic (CYP3A)No/minimal
LedipasvirFeces (major); hepatic and renal (minor)No/minimal
NS5B nucleos(t)ide polymerase inhibitors
SofosbuvirRenalNo/minimalDose reduction if moderate to severe renal impairment
NS5B non-nucleoside polymerase inhibitors
ABT-333Hepatic (CYP2C8 60%, CYP3A4 30% and CYP2D6 10%)No/minimal