A direct-acting antiviral (NS5A inhibitor) for hepatitis C
Daclatasvir
A modern hepatitis C medicine taken with sofosbuvir as part of a short course aimed at curing the infection.
What is Daclatasvir?
Daclatasvir is a modern medicine for hepatitis C, a virus that infects the liver. It is one of the direct-acting antivirals (a group that targets the virus directly) and is taken together with another medicine called sofosbuvir as part of a short, time-limited course that can cure the infection in most people. It is taken as a tablet and is generally well tolerated. One important safety point is that combining it (with sofosbuvir) and another heart medicine called amiodarone can cause a dangerously slow heartbeat, so that combination is avoided. It is prescribed and supervised by a specialist.
Education and reference only. This is a plain-language guide to Daclatasvir — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Daclatasvir is a direct-acting antiviral used to treat hepatitis C, a viral infection of the liver that can cause long-term damage. It works as an 'NS5A inhibitor', blocking a protein the virus needs. It is not used on its own but together with another antiviral, sofosbuvir, and sometimes other medicines, as a complete course usually lasting a few months. These modern combinations cure the great majority of people. It is taken by mouth as a tablet and is prescribed and supervised by a specialist liver or infection team.
How it works
Hepatitis C relies on several of its own proteins to copy itself inside liver cells. Daclatasvir blocks one of these, a protein called NS5A, which the virus needs both to make copies and to assemble new virus particles. Used together with sofosbuvir, which blocks a different step, the combination attacks the virus at more than one point at once. This makes it very hard for the virus to survive or become resistant, so a time-limited course can clear the infection completely in most people.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist medicine used to cure hepatitis C, taken with sofosbuvir as part of a short, time-limited course.
Practical use
How to take Daclatasvir
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, usually once a day, together with sofosbuvir as part of the full course.
- Finish the entire course even if you feel well, as completing it gives the best chance of a cure.
- Tell your team if you take the heart medicine amiodarone, as combining it with this treatment can cause a dangerously slow heartbeat.
- Give your team a full list of your medicines, as daclatasvir interacts with several of them.
- Attend the follow-up blood test after the course, which checks the virus has been cleared.
Weighing it up
Advantages & disadvantages of Daclatasvir
Advantages
- Part of a short, time-limited course that cures hepatitis C in most people.
- Generally very well tolerated, with mostly mild side effects.
- Taken as a simple tablet by mouth.
Disadvantages
- Must be taken with sofosbuvir, not on its own.
- Combined with sofosbuvir and the heart medicine amiodarone, it can cause a dangerously slow heartbeat, so that combination is avoided.
- Interacts with a number of other medicines, so the regimen must be checked.
Practical use
Good to know
The main thing to understand about daclatasvir is that it is part of a curative course rather than a long-term medicine: it is taken with sofosbuvir (and sometimes others) for a set number of weeks, and finishing the whole course is what gives the best chance of clearing the virus. It is generally very well tolerated, with mild effects such as tiredness, headache or nausea. The most important safety point is that taking it (with sofosbuvir) together with the heart medicine amiodarone can cause a dangerously slow heartbeat (bradycardia), so that combination is avoided or only used with very close monitoring. It also interacts with some other medicines, so a full medicines list is important. A blood test some weeks after the course checks the virus has gone.
Who should not take it / use with caution
- People who have had a serious allergic reaction to daclatasvir should not take it.
- The combination should be avoided in people taking the heart medicine amiodarone because of the risk of a dangerously slow heartbeat.
- It should not be used with certain medicines that strongly lower its levels, such as some epilepsy and tuberculosis drugs and St John's wort.
Monitoring
- A blood test some weeks after the course to confirm the virus has been cleared.
- Reviewing other medicines for interactions before and during treatment.
- Checking the heartbeat closely if there is any need to use it alongside amiodarone.
Side effects
- Tiredness, headache or nausea.
- Difficulty sleeping or mild stomach upset in some people.
- Rarely, a slow heartbeat, particularly if combined with amiodarone, which is why that combination is avoided.
Key interactions
- Taking it (with sofosbuvir) alongside the heart medicine amiodarone can cause a dangerously slow heartbeat and is avoided.
- Medicines that strongly speed up its breakdown, such as some epilepsy and tuberculosis drugs and St John's wort, can stop it working.
- Give a full list of all your medicines, as the doses of daclatasvir or other drugs may need adjusting.
Available as: Tablets taken by mouth.
Answers
Daclatasvir: frequently asked questions
What is daclatasvir used for?
It is a modern medicine used to cure hepatitis C, taken together with sofosbuvir as part of a short, time-limited course.
Why is it taken with sofosbuvir?
The two medicines attack the virus at different points, which makes the treatment far more effective and reduces the chance of resistance.
Why does amiodarone matter?
Taking this treatment together with the heart medicine amiodarone can cause a dangerously slow heartbeat, so the combination is avoided or only used with very close monitoring.
Does treatment last for life?
No. It is a curative course, usually a few months long; once finished, a blood test checks whether the virus has gone.
Is it well tolerated?
Yes, it is generally very well tolerated, with mostly mild effects such as tiredness, headache or nausea.
The wider class
About Direct-acting antiviral (hepatitis C, NS5A inhibitor)
Daclatasvir belongs to the direct-acting antiviral (hepatitis c, ns5a inhibitor) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.