Table 1.
Dosage recommendations for patients with Child-Pugh score A, B, or C
| HCV drug | Normal hepatic function | Degree of dirrhosis | ||
|---|---|---|---|---|
| Child-Pugh score A | Child-Pugh score B | Child-Pugh score C | ||
| Simeprevir | 150 mg od [11] | 150 mg od [11] | Contraindicated [11, 65] a | Contraindicated [11, 65]a |
| Asunaprevir* | 100 mg bid [14, 15] | 100 mg bid [14, 15] | Contraindicated[14, 15] | Contraindicated [14, 15] |
| Daclatasvir | 60 mg od [18] | 60 mg od [18] | 60 mg od [18] | 60 mg od [18] |
| Sofosbuvir | 400 mg od [23] | 400 mg od [23] | 40 0mg od [23] | 400 mg od [23] |
| Ledipasvir/sofosbuvir | 90 mg od/400 mg od [21] | 90 mg od/400 mg od [21] | 90 mg od/400 mg od [21] | 90 mg od/400 mg od [21] |
| Velpatasvir/sofosbuvirb | 100 mg od/ 400 mg od [37] | 100 mg od/ 400 mg od [37, 77] | 100 mg od/ 400 mg od [37, 77] | Unknown |
| Grazoprevir/elbasvir | 100 mg od/50 mg od [93, 94] | 100 mg od/50 mg od [93, 94] | Contraindicated [50] | Contraindicated [50] |
| Ombitasvir/paritaprevir/ritonavir | 25 mg od/150 mg od/100 mg od [51, 52] | 25 mg od/150 mg od/100 mg od [51, 52] | Contraindicated [54, 55] c | Contraindicated [51] |
| Dasabuvir | 250 mg bid [52, 53] | 250 mg bid [52, 53] | Contraindicated [54, 55] c | Contraindicated [53] |
| Ribavirin | <75kg = 500 mg bid≥75kg = 600 mg bid [56] | <75kg = 500 mg bid≥75kg = 600 mg bid [56] | <75kg = 500 mg bid≥75kg = 600 mg bid [56] | <75kg = 500 mg bid≥75kg = 600 mg bid [56] |
bid twice dialy, EMA European Medicines Agency, FDA Food and Drug Administration, HCV hepatitis C virus, od once daily, SmPC summary of product characteristics
aThe US FDA prescribing information for OlysioTM comments that: the potential risks and benefits of OLYSIOTM (Janssen Therapeutics, Titusville, NJ, USA) should be carefully considered prior to use in patients with moderate or severe hepatic impairment. The EMA SmPC comments that: the safety and efficacy of OLYSIOTM have not been studied in HCV-infected patients with moderate or severe hepatic impairment (Child-Pugh score B or C); therefore, particular caution is recommended when prescribing OLYSIOTM to HCV-infected patients with moderate or severe hepatic impairment
bNo SmPC or prescribing information was available at time of publication
cThe SmPC Viekierax® (AbbVie, North Chicago, IL, USA) and Exviera ® (AbbVie, North Chicago, IL, USA) state that efficacy and safety are not studied in Child-Pugh score B patients. The US Prescribing information has been updated and both Child -Pugh score B and C are contraindicated