Drug-Drug Interactions in Children and Adolescents Receiving Ledipasvir/Sofosbuvir for the Treatment of Hepatitis C Virus Infection.

Autor: Abdullatif HM; Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt. halamohsen@kasralainy.edu.eg., Ramzi R; Kasr Alainy Drug Information Center, Cairo University, Cairo, Egypt., Mogahed EA; Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt., Ghobrial CM; Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt., El Rasheed Abd El Zaher BA; Kasr Alainy Drug Information Center, Cairo University, Cairo, Egypt., El Raziky MS; Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt., El-Karaksy HM; Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt.
Jazyk: angličtina
Zdroj: Clinical drug investigation [Clin Drug Investig] 2019 Sep; Vol. 39 (9), pp. 857-864.
DOI: 10.1007/s40261-019-00805-5
Abstrakt: Background and Objective: Drug-drug interactions need to be considered to optimize the pharmacotherapeutic outcome of direct-acting antivirals. The aim of this study was to report on possible drug-drug interactions between ledipasvir/sofosbuvir and other medications received by children and adolescents with hepatitis C virus, in addition to suggested management for these drug-drug interactions.
Methods: Hepatitis C virus-infected children and adolescents, 12-17 years of age and/or weighing ≥ 35 kg, who presented to the Pediatric Hepatology Unit at Cairo University Pediatric Hospitals for ledipasvir/sofosbuvir treatment were included. Medication history was taken including long-term medications for chronic conditions and on-demand medications for inter-current illnesses. Medications were reviewed by the Kasr Alainy Drug Information Center to identify possible drug-drug interactions with prescribed ledipasvir/sofosbuvir and their management. HEP Drug Interactions provided by the University of Liverpool, Lexicomp ® , and Medscape were the utilized references. Each drug-drug interaction was assigned a risk rating of A, B, C, D, or X.
Results: Sixty hepatitis C virus-infected children and adolescents assigned to receive ledipasvir/sofosbuvir were enrolled. Thirty percent of patients had associated chronic co-morbid conditions. The overall number of medications received was 48; 39 were prescribed as long-term medications with a median of 3 (interquartile range 4.24) medications per patient. Proton pump inhibitors, antacids, histamine H 2 receptor antagonists, sodium bicarbonate, and colchicine were reported to be associated with a drug-drug interaction risk D necessitating therapy modification, which occurred prior to administration.
Conclusions: Early identification and prompt response to drug-drug interactions with the aid of pharmacists optimize the pharmacotherapeutic outcome and eliminate possible morbidities when using direct-acting antivirals in children and adolescents with hepatitis C virus.
Databáze: MEDLINE
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