New antiviral drugs tablets had been delivered for the treatment of Hepatitis C virus, like Sovaldi (sofosbuvir) and other similar drugs. I'm being asked, as a cardiologist, if the patient is fit or not, from the cardiovascular point of view, to receive these types of drugs.So, I'm asking about the cardiovascular diseases and/or conditions that may represent a relative or an absolute contraindication for the use of such drugs.
Hello,
Sofosbuvir has been associated with severe bradycardia in patients taking amiodarone. As far as I know, the risk is due to the co-administration of the two drugs, and not due to the cardiovascular disease itself.
Ombitasvir/Paritaprevir/ritonavir has multiple interactions with drugs that undergo liver metabolism by CYP3A4, so it could be more problematic in your field (due to statin use, for example).
Any clinician prescribing anti-HCV drugs is advised to check for drug interactions (try http://www.hep-druginteractions.org/checker).
As above, there are some boxed warnings and then concerns about other less worrisome drug interactions. Sof and amioderone concurrently taken is associated with symptomatic bradycardia. Statins, fibrates and other less commonly used antiarrythmics can have drug-drug interactions that increase or decrease effectiveness of both the hcv and other meds. Not much concern with antihypertensives. There is no association between HCV meds and causing or complicating cardiac diseases (ischemia/valve/myopathy/rythym) (unlike interferon that had issues with arrythmias). Ribavirin is still used in some combinations, and can contribute to cardiac issues related to anemia (shortened RBC survival without concomittant increase in RBC production).
Cardiovascular: Increased risk of bradycardia during concurrent amiodarone among patients with concomitant beta blocker use, underlying cardiac comorbidities, and advanced liver disease; monitoring recommended