DDInter542 DDInter1695
Dicoumarol is an oral anticoagulant agent that works by interfering with the metabolism of vitamin K. In addition to its clinical use, it is also used in biochemical experiments as an inhibitor of reductases.
Sofosbuvir (tradename Sovaldi) is a direct acting antiviral medication used as part of combination therapy to treat chronic Hepatitis C, an infectious liver disease caused by infection with Hepatitis C Virus (HCV). HCV is a single-stranded RNA virus that is categorized into nine distinct genotypes, with genotype 1 being the most common in the United States, and affecting 72% of all chronic HCV patients . Treatment options for chronic Hepatitis C have advanced significantly since 2011, with the development of Direct Acting Antivirals (DAAs) such as sofosbuvir. As a prodrug nucleotide analog, Sofosbuvir is metabolized into its active form as the antiviral agent 2'-deoxy-2'-α-fluoro-β-C-methyluridine-5'-triphosphate (also known as GS-461203), which acts as a defective substrate for NS5B (non-structural protein 5B) [synthesis]. NS5B, an RNA-dependent RNA polymerase, is essential for the transcription of Hepatitis C viral RNA and for its high replicative rate and genetic diversity . Sofosbuvir and other direct acting antivirals are therefore very potent options for the treatment of Hepatitis C, as they exhibit a high barrier to the development of resistance . This is an important advantage relative to HCV drugs that target other viral enzymes such as the protease, for which rapid development of resistance has proven to be an important cause of therapeutic failure. In a joint recommendation published in 2016, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) recommend Sofosbuvir as first line therapy in combination with other antivirals for all six genotypes of Hepatitis C . Depending on the genotype, sofosbuvir is often used in combination with other antivirals such as , , , , , , , , or with the intent to cure, or achieve a sustained virologic response (SVR), after 12 weeks of daily therapy. SVR and eradication of HCV infection is associated with significant long-term health benefits including reduced liver-related damage, improved quality of life, reduced incidence of Hepatocellular Carcinoma, and reduced all-cause mortality . Treatment with direct acting antivirals such as sofosbuvir is associated with very minimal side effects, with the most common being headache and fatigue [FDA Label]. Lack of significant side effects and short duration of therapy is a considerable advantage over older interferon- and ribavirin-based regimens, which were limited by infusion site reactions, reduced blood count, and neuropsychiatric effects . Since 2014, sofosbuvir has been available as a fixed dose combination product with (tradename Harvoni) used for the treatment of chronic Hepatitis C. Approved in October 2014 by the FDA, Harvoni is indicated for the treatment of HCV genotypes 1, 4, 5, and 6 with or without depending on the level of liver damage or cirrhosis [FDA Label]. When combined together, ledipasvir and sofosbuvir as the combination product Harvoni has been shown to achieve a SVR between 93 and 99% after 12 weeks of treatment . Its use has also proven successful in the treatment of HCV in patients co-infected with HIV . Sofosbuvir is also available as a fixed dose combination product with as the commercially available product Epclusa. First approved in June 2016, Epclusa is the first combination HCV product indicated for the treatment of all genotypes of Hepatitis C with or without cirrhosis. Epclusa is also currently the most potent HCV antiviral medication on the market with a sustained virologic response (SVR) after 12 weeks of therapy of 93-99% depending on genotype and level of cirrhosis . Both Canadian and American guidelines list Epclusa as a first line recommendation for all genotypes of HCV [L852, A19626]. Notably, sofosbuvir has come under intense scrutiny since its release to market in 2013. With the price per pill set at $1000, a 12-week treatment can cost upwards of $84,000 per patient .
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) resembles {v} (Compound) Phenprocoumon
Phenprocoumon {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Fostamatinib
Fostamatinib {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Apalutamide
Apalutamide {u} may lead to a major life threatening interaction when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) binds {v} (Gene) CYP2C9
CYP2C9 {u} (Gene) is bound by {v} (Compound) Enzalutamide
Enzalutamide {u} may lead to a major life threatening interaction when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) resembles {v} (Compound) Acenocoumarol
Acenocoumarol {u} (Compound) causes {v} (Side Effect) Body temperature increased
Body temperature increased {u} (Side Effect) is caused by {v} (Compound) Sofosbuvir
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Enzalutamide
Enzalutamide {u} may lead to a major life threatening interaction when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) binds {v} (Gene) VKORC1
VKORC1 {u} (Gene) is bound by {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Sofosbuvir
Dicoumarol {u} (Compound) downregulates {v} (Gene) POLR2I
POLR2I {u} (Gene) is regulated by {v} (Gene) ABCB1
ABCB1 {u} (Gene) is bound by {v} (Compound) Sofosbuvir
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Sofosbuvir
Dicoumarol (Compound) resembles Phenprocoumon (Compound) and Phenprocoumon (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Sofosbuvir
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Fostamatinib and Fostamatinib may cause a moderate interaction that could exacerbate diseases when taken with Sofosbuvir
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Apalutamide and Apalutamide may lead to a major life threatening interaction when taken with Sofosbuvir
Dicoumarol (Compound) binds CYP2C9 (Gene) and CYP2C9 (Gene) is bound by Enzalutamide (Compound) and Enzalutamide may lead to a major life threatening interaction when taken with Sofosbuvir
Dicoumarol (Compound) resembles Acenocoumarol (Compound) and Acenocoumarol (Compound) causes Body temperature increased (Side Effect) and Body temperature increased (Side Effect) is caused by Sofosbuvir (Compound)
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Enzalutamide and Enzalutamide may lead to a major life threatening interaction when taken with Sofosbuvir
Dicoumarol (Compound) binds VKORC1 (Gene) and VKORC1 (Gene) is bound by Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Sofosbuvir
Dicoumarol (Compound) downregulates POLR2I (Gene) and POLR2I (Gene) is regulated by ABCB1 (Gene) and ABCB1 (Gene) is bound by Sofosbuvir (Compound)