Hepcdac (Daclatasvir)

What This Medicine Is

How It Works, and Why It Needs a Partner

The reasoning is straightforward:

Dosage Guide

The dose moves in both directions, which is unusual.

Situation	Dose	Direction	Key Note
Standard	60 mg once daily	Baseline	With or without food
With strong CYP3A4 inhibitors	30 mg once daily	Reduced	Half the standard dose
With moderate CYP3A4 inducers	90 mg once daily	Increased	Half as much again
With strong CYP3A inducers	Not to be used	Contraindicated	See the list below
Course length	Usually twelve weeks	Not applicable	Longer with cirrhosis
Partner medicine	Sofosbuvir 400 mg daily	Always	Never daclatasvir alone
Where ribavirin is added	Decompensated cirrhosis	The prescriber	Also post-transplant
Children	Studies not performed	Not established	Per one clinic reference
Older patients	No specific problems found	Standard dose	Per the same reference
Steady state	Reached after about four days	Not applicable	Once-daily dosing

Why a dose increase is unusual:

The Amiodarone Warning in Detail

Point	What the Documents State
What happens	Severe bradycardia and heart block
With what	Daclatasvir, sofosbuvir and amiodarone together
Also relevant	Other medicines that lower heart rate
Severity	Cases are potentially life threatening
When amiodarone may be used	Only where alternatives fail or are contraindicated
If it must be used	Patients are closely monitored at initiation
Also applies to	Anyone who stopped amiodarone in recent months
Why	The medicine persists long after it is stopped
Greater risk if	A beta-blocker is also being taken
The clinic position	Coadministration is not advised

What bradycardia feels like:

What this means in practice:

Precautions

Medicines That Must Not Be Combined

Other Points From the Sources

Before-Use Checklist

Side Effects

Effects named on one Indian pharmacy page:

Effect	Category	What It Feels Like	What to Do
Headache	Named	Head pain	Report if persistent
Fatigue	Named	Tiredness	Common during treatment
Weakness	Named	Reduced strength	Report if marked
Nausea	Named	Queasy stomach	Report if persistent
Diarrhoea	Named	Loose stools	Report if persistent
Dizziness	Named	Light-headedness	May signal a slow pulse
Lightheadedness	Named	Feeling faint	May signal a slow pulse
Confusion	Named	Difficulty thinking clearly	Report promptly
Chest pain	Named	Pain or discomfort	Seek urgent assessment
Shortness of breath	Named	Breathlessness	Seek urgent assessment
Severe bradycardia	Serious	Very slow heartbeat	Emergency – seek care
Hepatitis B reactivation	Serious	Jaundice, worsening tests	Monitored by the specialist

A point about four of those entries:

Warning Signs – Seek Medical Help

Seek urgent care if you have:

Why completing the course matters:

Pricing, and a Calculation Problem

Maker	Pack Price	Stated Per Tablet
Aprazer Healthcare	About 3,500 rupees	About 102.50 rupees
Zydus Healthcare	About 5,000 rupees	About 146.43 rupees
Mylan Pharmaceuticals	About 5,000 rupees	About 146.43 rupees
Natco Pharma	About 6,000 rupees	About 175.71 rupees
Hetero, Strides and Dr Reddy’s	About 6,000 rupees	About 175.71 rupees
Cipla	About 7,000 rupees	About 205.00 rupees
Torrent Pharmaceuticals	About 6,000 rupees	About 214.29 rupees

The figures do not divide consistently:

An Honest Assessment for the Retailer

What can fairly be said:

What a buyer must be told plainly:

Storage Instructions