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

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Abstract

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 H2 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.

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Authors and Affiliations

  1. Pediatric Hepatology Unit, Cairo University Pediatric Hospital, El Saray Street, El Manial, Cairo, 11956, Egypt

    Hala Mohsen Abdullatif, Engy Adel Mogahed, Carolyne Morcos Ghobrial, Mona S. El Raziky & Hanaa Mostafa El-Karaksy

  2. Kasr Alainy Drug Information Center, Cairo University, Cairo, Egypt

    Rania Ramzi & Basma Abd El Rasheed Abd El Zaher

Authors
  1. Hala Mohsen Abdullatif
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  2. Rania Ramzi
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  3. Engy Adel Mogahed
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  4. Carolyne Morcos Ghobrial
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  5. Basma Abd El Rasheed Abd El Zaher
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  6. Mona S. El Raziky
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  7. Hanaa Mostafa El-Karaksy
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Corresponding author

Correspondence to Hala Mohsen Abdullatif.

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Funding

No funding was received for the preparation of this article.

Conflict of interest

Hala Mohsen Abdullatif, Rania Ramzi, Engy Adel Mogahed, Carolyne Morcos Ghobrial, Basma Abd El Rasheed Abd El Zaher, Mona S. El Raziky, and Hanaa Mostafa El-Karaksy have no conflicts of interest that are directly relevant to the content of this article.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Abdullatif, H.M., Ramzi, R., Mogahed, E.A. et al. Drug–Drug Interactions in Children and Adolescents Receiving Ledipasvir/Sofosbuvir for the Treatment of Hepatitis C Virus Infection. Clin Drug Investig 39, 857–864 (2019). https://doi.org/10.1007/s40261-019-00805-5

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  • DOI: https://doi.org/10.1007/s40261-019-00805-5

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