PHARMACIST ROLE:
• Closely monitor drug interactions.
• Most of these Hep-C drugs are blockers off CYP-450-3A4, and can cause significant interactions with statins, etc.
o Watch out for myopathy due to increased statin levels.
o Rosuvastatin and Pravastatin do not undergo CYP 450 metabolism and might be a better choice.
• Avoid CYP inducers like carbamazepine, phenobarbital, and OTC-St. John’s Wort, as they speed up metabolism of Hep-C drugs
• Avoid Proton Pump Inhibitors with this class of drugs (especially Epclusa).
o Famotidine might be a better choice.
• Adherence is a big deal with these drugs to insure complete eradication of the hep-C virus.
• You might have to do some “digging” as these drugs are most often filled at specialty pharmacies.