Table 2. Current hepatitis C antiviral treatments .

Drug	Mechanism of action	Genotype coverage	Key drug interactions and recommendations	Contraindications and warnings*
Sofosbuvir	NS5B RNA polymerase inhibitor (chain terminator)	Pan-genotypic, must be used in combination with another drug.	Phenytoin should not be co-prescribed. Not recommended with amiodarone as symptomatic bradycardia has been reported.	Sofosbuvir concentrations increase in renal impairment. Dose adjustment not necessary in mild and moderate impairment. Safety has not been established when eGFR <30 mL/min/1.73 m2. If these drugs are the only option, closer monitoring for adverse effects is advised.
Sofosbuvir/ ledipasvir	NS5A inhibitor + polymerase inhibitor	Approved only for geno type 1 (effective also in genotypes 4, 6).	Phenytoin should not be co-prescribed. Not recommended with amiodarone as symptomatic bradycardia has been reported. Absorption is reduced with proton pump inhibitors. Some statins may require dose reduction – rosuvastatin should not be co-prescribed.
Sofosbuvir/ velpatasvir	NS5B RNA polymerase inhibitor + NS5A inhibitor	Genotypes 1–6	Co-administration of potent CYP2B6, CYP2C8 and CYP3A4 inducers is not recommended. Not recommended with amiodarone as symptomatic bradycardia has been reported.
Daclatasvir	NS5A inhibitor	Approved only for genotypes 1 and 3 but pan-genotypic. Always used with sofosbuvir.	Phenytoin should not be co-prescribed. Some drug–drug interactions occur. Some statins may require dose reduction.	–
Paritaprevir/ ritonavir/ ombitasvir + dasabuvir	Ritonavir-boosted NS3/4A protease inhibitor + NS5A inhibitor + non-nucleoside polymerase inhibitor	Genotype 1 only	Phenytoin should not be co-prescribed. Multiple drug–drug interactions occur – ritonavir is a potent inhibitor of CYP3A4. Some statins may require dose reduction – simvastatin or atorvastatin should not be co-prescribed.	Can be used in renal failure. Contraindicated in liver failure.
Elbasvir/ grazoprevir	NS5A inhibitor + NS3/4A protease inhibitor	Genotypes 1 and 4	Phenytoin should not be co-prescribed. Multiple drug–drug interactions occur. Some statins may require dose reduction.	Can be used in renal failure. Contraindicated in liver failure.
Ribavirin	Nucleoside-analogue	Pan-genotypic, must be used in combination with other drugs.	–	Contraindicated in pregnancy. Dose adjustment needed in renal impairment.

CYP cytochrome P450

eGFR estimated glomerular filtration rate

* Antiviral treatments should not be administered during pregnancy or lactation.