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, 55 (12), 1471-1494

Drug-Drug Interactions Between Direct-Acting Antivirals and Psychoactive Medications


Drug-Drug Interactions Between Direct-Acting Antivirals and Psychoactive Medications

E J Smolders et al. Clin Pharmacokinet.


Treatment options for chronic hepatitis C virus (HCV) infection have drastically changed since the development and licensing of new potent direct-acting antivirals (DAAs). The majority of DAAs are extensively metabolized by liver enzymes and have the ability to influence cytochrome P450 (CYP) enzymes. Additionally, these DAAs are both substrates and inhibitors of drug transporters, which makes the DAAs both possible victims or perpetrators of drug-drug interactions (DDIs). There is a high prevalence of mental illnesses such as depression or psychosis in HCV-infected patients; therefore, psychoactive medications are frequently co-administered with DAAs. The majority of these psychoactive medications are also metabolized by CYP enzymes but remarkably little information is available on DDIs between psychoactive medications and DAAs. Hence, the aim of this review is to provide an overview of the interaction mechanisms between DAAs and psychoactive agents. In addition, we describe evidenced-based interactions between DAAs and psychoactive drugs and identify safe options for the simultaneous treatment of mental illnesses and chronic HCV infection.

Conflict of interest statement

Compliance with Ethical Standards Funding No funding was used in the preparation of this review. Conflict of interest E.J. Smolders and C.T.M.M. de Kanter declare that they have no conflicts of interest that are directly relevant to the content of this review. R.J. de Knegt received sponsorship/research grants from BMS and Janssen; is a consultant for AbbVie, BMS, Gilead, Roche, and Janssen; and has delivered lectures for AbbVie, Janssen, Gilead, and Roche. J.P.H. Drenth is on the advisory boards for AbbVie, BMS, Gilead, Janssen, and Merck and received sponsorship/research grants from AbbVie and Janssen. D.M. Burger is on the advisory boards for AbbVie, BMS, Gilead, Janssen, and Merck and received sponsorship/research grants from BMS, Janssen, Merck, and Viiv. However, these conflicts of interests did not influence the preparation of this review.

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