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Available in 18 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-18" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">18 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AF%D8%A7%D9%83%D9%84%D8%A7%D8%AA%D8%A7%D8%B2%D9%81%D8%B1" title="داكلاتازفر – Arabic" lang="ar" hreflang="ar" data-title="داكلاتازفر" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Daclatasvir" title="Daclatasvir – German" lang="de" hreflang="de" data-title="Daclatasvir" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Daclatasvir" title="Daclatasvir – Spanish" lang="es" hreflang="es" data-title="Daclatasvir" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AF%D8%A7%DA%A9%D9%84%D8%A7%D8%AA%D8%A7%D8%B3%D9%88%DB%8C%D8%B1" title="داکلاتاسویر – Persian" lang="fa" hreflang="fa" data-title="داکلاتاسویر" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Daclatasvir" title="Daclatasvir – French" lang="fr" hreflang="fr" data-title="Daclatasvir" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Daklatasvir" title="Daklatasvir – Indonesian" lang="id" hreflang="id" data-title="Daklatasvir" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%80%E3%82%AF%E3%83%A9%E3%82%BF%E3%82%B9%E3%83%93%E3%83%AB" title="ダクラタスビル – Japanese" lang="ja" hreflang="ja" data-title="ダクラタスビル" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%A1%E0%AC%BE%E0%AC%95%E0%AD%8D%E0%AC%B2%E0%AC%BE%E0%AC%9F%E0%AC%BE%E0%AC%B8%E0%AC%AD%E0%AC%BF%E0%AC%B0" title="ଡାକ୍ଲାଟାସଭିର – Odia" lang="or" hreflang="or" data-title="ଡାକ୍ଲାଟାସଭିର" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Daklataswir" title="Daklataswir – Polish" lang="pl" hreflang="pl" data-title="Daklataswir" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%94%D0%B0%D0%BA%D0%BB%D0%B0%D1%82%D0%B0%D1%81%D0%B2%D0%B8%D1%80" title="Даклатасвир – Russian" lang="ru" hreflang="ru" data-title="Даклатасвир" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Daklatasvir" title="Daklatasvir – Slovenian" lang="sl" hreflang="sl" data-title="Daklatasvir" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Daklatasvir" title="Daklatasvir – Serbian" lang="sr" hreflang="sr" data-title="Daklatasvir" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Daklatasvir" title="Daklatasvir – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Daklatasvir" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Daklatasviiri" title="Daklatasviiri – Finnish" lang="fi" hreflang="fi" data-title="Daklatasviiri" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Daclatasvir" title="Daclatasvir – Turkish" lang="tr" hreflang="tr" data-title="Daclatasvir" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%94%D0%B0%D0%BA%D0%BB%D0%B0%D1%82%D0%B0%D1%81%D0%B2%D1%96%D1%80" title="Даклатасвір – Ukrainian" lang="uk" hreflang="uk" data-title="Даклатасвір" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Daclatasvir" title="Daclatasvir – Vietnamese" lang="vi" hreflang="vi" data-title="Daclatasvir" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%81%94%E5%8D%A1%E4%BB%96%E9%9F%8B" title="達卡他韋 – Chinese" lang="zh" hreflang="zh" data-title="達卡他韋" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a 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.infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Daclatasvir">Daclatasvir</span></caption><tbody><tr><td colspan="2" class="infobox-image"><span class="skin-invert-image" typeof="mw:File"><a href="/wiki/File:Daclatasvir.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/ba/Daclatasvir.svg/330px-Daclatasvir.svg.png" decoding="async" width="275" height="61" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/ba/Daclatasvir.svg/500px-Daclatasvir.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/ba/Daclatasvir.svg/550px-Daclatasvir.svg.png 2x" data-file-width="512" data-file-height="114" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Pronunciation</th><td class="infobox-data"><span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="'d' in 'dye'">d</span><span title="/ə/: 'a' in 'about'">ə</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'k' in 'kind'">k</span><span title="'l' in 'lie'">l</span><span title="/æ/: 'a' in 'bad'">æ</span><span title="'t' in 'tie'">t</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'s' in 'sigh'">s</span><span title="'v' in 'vie'">v</span><span title="/ɪər/: 'ear' in 'near'">ɪər</span></span>/</a></span></span><br /><a href="/wiki/Help:Pronunciation_respelling_key" title="Help:Pronunciation respelling key"><i title="English pronunciation respelling">də-<span style="font-size:90%">KLAT</span>-əs-veer</i></a> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Daklinza</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/daclatasvir-dihydrochloride.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a615044.html">a615044</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Daclatasvir">Daclatasvir</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Pregnancy_category" title="Pregnancy category">Pregnancy<br />category</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> B3</li> <li class="mw-empty-elt"></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><a href="/wiki/ATC_code_J05" title="ATC code J05">J05AP07</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=J05AP07">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Australia">AU</abbr>:</small> <a href="/wiki/Standard_for_the_Uniform_Scheduling_of_Medicines_and_Poisons#Schedule_4" title="Standard for the Uniform Scheduling of Medicines and Poisons">S4</a> (Prescription only)<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="Canada">CA</abbr></small>: <a href="/wiki/Prescription_drug" title="Prescription drug"> ℞-only</a><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="United Kingdom">UK</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">POM</a> (Prescription only)<sup id="cite_ref-UKlabel_3-0" class="reference"><a href="#cite_note-UKlabel-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a><sup id="cite_ref-Daklinza_FDA_label_4-0" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li> <li>In general: ℞ (Prescription only)</li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Bioavailability" title="Bioavailability">Bioavailability</a></th><td class="infobox-data">67%<sup id="cite_ref-Daklinza_FDA_label_4-1" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">99%<sup id="cite_ref-Daklinza_FDA_label_4-2" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_metabolism" title="Drug metabolism">Metabolism</a></th><td class="infobox-data"><a href="/wiki/CYP3A" title="CYP3A">CYP3A</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">12–15 hours</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data">Fecal (53% as unchanged drug), kidney</td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Identifiers</th></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/IUPAC_nomenclature_of_chemistry" title="IUPAC nomenclature of chemistry">IUPAC name</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all; text-align:left; padding-left:1.5em; text-indent:-1.5em;"><li style="line-height: inherit; margin: 0"><div style="font-size: 97%;">Dimethyl <i>N</i>,<i>N</i><span class="nowrap" style="padding-left:0.1em;">'</span>-([1,1'-biphenyl]-4,4'-diylbis{1<i>H</i>-imidazole-5,2-diyl-[(2<i>S</i>)-pyrrolidine-2,1-diyl] [(2<i>S</i>)-3-methyl-1-oxobutane-1,2-diyl]})dicarbamate</div></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=1009119-64-5">1009119-64-5</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/25154714">25154714</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB09102">DB09102</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.24609522.html">24609522</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/LI2427F9CI">LI2427F9CI</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D10065">D10065</a></span></li><li>as salt: <span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D10105">D10105</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEBI" title="ChEBI">ChEBI</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:82977">CHEBI:82977</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CompTox_Chemicals_Dashboard" title="CompTox Chemicals Dashboard">CompTox Dashboard</a> <span style="font-weight:normal">(<abbr title="U.S. Environmental Protection Agency">EPA</abbr>)</span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="comptox.epa.gov"><a rel="nofollow" class="external text" href="https://comptox.epa.gov/dashboard/chemical/details/DTXSID901026404">DTXSID901026404</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q5207712#P3117" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>40</sub><span title="Hydrogen">H</span><sub>50</sub><span title="Nitrogen">N</span><sub>8</sub><span title="Oxygen">O</span><sub>6</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002738890000000000♠"></span>738.890</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409" /><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=CC%28C%29%5BC%40%40H%5D%28C%28%3DO%29N1CCC%5BC%40H%5D1c2%5BnH%5Dc%28cn2%29c3ccc%28cc3%29c4ccc%28cc4%29c5cnc%28%5BnH%5D5%29%5BC%40%40H%5D6CCCN6C%28%3DO%29%5BC%40H%5D%28C%28C%29C%29NC%28%3DO%29OC%29NC%28%3DO%29OC">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">CC(C)[C@@H](C(=O)N1CCC[C@H]1c2[nH]c(cn2)c3ccc(cc3)c4ccc(cc4)c5cnc([nH]5)[C@@H]6CCCN6C(=O)[C@H](C(C)C)NC(=O)OC)NC(=O)OC</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">InChI=1S/C40H50N8O6/c1-23(2)33(45-39(51)53-5)37(49)47-19-7-9-31(47)35-41-21-29(43-35)27-15-11-25(12-16-27)26-13-17-28(18-14-26)30-22-42-36(44-30)32-10-8-20-48(32)38(50)34(24(3)4)46-40(52)54-6/h11-18,21-24,31-34H,7-10,19-20H2,1-6H3,(H,41,43)(H,42,44)(H,45,51)(H,46,52)/t31-,32-,33-,34-/m0/s1</div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:FKRSSPOQAMALKA-CUPIEXAXSA-N</div></li></ul> </div></td></tr></tbody></table> <p><b>Daclatasvir</b>, sold under the brand name <b>Daklinza</b>, is an <a href="/wiki/Antiviral_medication" class="mw-redirect" title="Antiviral medication">antiviral medication</a> used in combination with other medications to treat <a href="/wiki/Hepatitis_C" title="Hepatitis C">hepatitis C</a> (HCV).<sup id="cite_ref-AHFS2016_5-0" class="reference"><a href="#cite_note-AHFS2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The other medications used in combination include <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>, <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>, and <a href="/wiki/Interferon#Drug_formulations" title="Interferon">interferon</a>, vary depending on the virus type and whether the person has <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>.<sup id="cite_ref-UKlabel_3-1" class="reference"><a href="#cite_note-UKlabel-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> It is taken by mouth.<sup id="cite_ref-AHFS2016_5-1" class="reference"><a href="#cite_note-AHFS2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Common side effects when used with sofusbivir and daclatasvir include headache, <a href="/wiki/Fatigue_(medicine)" class="mw-redirect" title="Fatigue (medicine)">feeling tired</a>, and nausea.<sup id="cite_ref-Daklinza_FDA_label_4-3" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> With daclatasvir, sofosbuvir, and ribavirin the most common side effects are headache, feeling tired, nausea, and <a href="/wiki/Hemolytic_anemia" title="Hemolytic anemia">red blood cell breakdown</a>.<sup id="cite_ref-Daklinza_FDA_label_4-4" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It should not be used with <a href="/wiki/St._John%27s_wort" class="mw-redirect" title="St. John's wort">St. John's wort</a>, <a href="/wiki/Rifampin" class="mw-redirect" title="Rifampin">rifampin</a>, or <a href="/wiki/Carbamazepine" title="Carbamazepine">carbamazepine</a>.<sup id="cite_ref-AHFS2016_5-2" class="reference"><a href="#cite_note-AHFS2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> It works by inhibiting the HCV protein <a href="/wiki/NS5A" class="mw-redirect" title="NS5A">NS5A</a>.<sup id="cite_ref-UKlabel_3-2" class="reference"><a href="#cite_note-UKlabel-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Daclatasvir was approved for use in the European Union in 2014, and the United States and India in 2015.<sup id="cite_ref-amFAR_6-0" class="reference"><a href="#cite_note-amFAR-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a>.<sup id="cite_ref-WHO23rd_7-0" class="reference"><a href="#cite_note-WHO23rd-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>The brand Daklinza is being withdrawn by Bristol Myers Squibb in countries where the drug is not typically prescribed, and Bristol Myers Squibb says it will not enforce its patents in those countries.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_use">Medical use</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=1" title="Edit section: Medical use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Daclatasvir is used only in combination therapy for the treatment of hepatitis C genotype 1, 3, or 4 infections; the agents used in combination, which include <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>, <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>, and <a href="/wiki/Interferon#Drug_formulations" title="Interferon">interferon</a>, vary based on the virus genotype, whether the person has cirrhosis and if a liver transplantation took place.<sup id="cite_ref-Daklinza2017_9-0" class="reference"><a href="#cite_note-Daklinza2017-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-UKlabel_3-3" class="reference"><a href="#cite_note-UKlabel-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Pol2016rev_10-0" class="reference"><a href="#cite_note-Pol2016rev-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>It is not known whether daclatasvir passes into breastmilk or has any effect on infants.<sup id="cite_ref-Daklinza_FDA_label_4-5" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Adverse_effects">Adverse effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=2" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is a serious risk of <a href="/wiki/Bradycardia" title="Bradycardia">bradycardia</a> when daclatasvir is used with <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> and <a href="/wiki/Amiodarone" title="Amiodarone">amiodarone</a>.<sup id="cite_ref-Daklinza_FDA_label_4-6" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Because it has not been extensively studied as a single agent, it is unknown what specific side effects are linked to this medication alone. Adverse events on daclatasvir have only been reported on combination therapy with <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> or triple therapy with <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>/<a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>.<sup id="cite_ref-Daklinza_FDA_label_4-7" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Common adverse events occurring in >5% of people on combination therapy (<a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> + daclatasvir) include headache and fatigue; in triple therapy (daclatasvir + <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> + <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>) the most common adverse events (>10%) include headache, fatigue, nausea and <a href="/wiki/Hemolytic_anemia" title="Hemolytic anemia">hemolytic anemia</a>.<sup id="cite_ref-Daklinza_FDA_label_4-8" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Daclatasvir could cause hepatitis B re-activation in people co-infected with hepatitis B and C viruses. The <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA) has recommended screening all people for hepatitis B before starting daclatasvir for hepatitis C in order to minimize the risk of hepatitis B reactivation.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Interactions">Interactions</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=3" title="Edit section: Interactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Concomitant use of drugs that are strong inducers of the <a href="/wiki/Cytochrome_P450" title="Cytochrome P450">cytochrome P450</a> <a href="/wiki/CYP3A" title="CYP3A">CYP3A</a> is contraindicated due to decreased therapeutic effect and resistance of drug.<sup id="cite_ref-Daklinza_FDA_label_4-9" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Some common drugs that are strong CYP3A inducers include <a href="/wiki/Dexamethasone" title="Dexamethasone">dexamethasone</a>, <a href="/wiki/Phenytoin" title="Phenytoin">phenytoin</a>, <a href="/wiki/Carbamazepine" title="Carbamazepine">carbamazepine</a>, <a href="/wiki/Rifampicin" title="Rifampicin">rifampin</a> and <a href="/wiki/Hypericum_perforatum" title="Hypericum perforatum">St. John's Wort</a>.<sup id="cite_ref-Daklinza_FDA_label_4-10" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Daclatasvir is a CYP3A and <a href="/wiki/P-glycoprotein" title="P-glycoprotein">p-glycoprotein</a> substrate, therefore, drugs that are strong inducers or inhibitors of these enzyme will interfere with daclatasvir levels in the body.<sup id="cite_ref-Daklinza_FDA_label_4-11" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Dose modifications are made with concomitant use of daclatasvir and drugs that affect CYP3A or p-gp. When taking daclatasvir with <a href="/wiki/Non-nucleoside_reverse_transcriptase_inhibitors" class="mw-redirect" title="Non-nucleoside reverse transcriptase inhibitors">non-nucleoside reverse transcriptase inhibitors</a>, the dose of daclatasvir is increased to overcome CYP3A induction. The dose for daclatasvir should be lowered when taking with antifungals, such as <a href="/wiki/Ketoconazole" title="Ketoconazole">ketoconazole</a>. Currently, there are no required dosage adjustments with concurrent use of daclatasvir and immunosuppressants, narcotic analgesics, antidepressants, sedatives, and cardiovascular agents.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>Concurrent use with <a href="/wiki/Amiodarone" title="Amiodarone">amiodarone</a>, <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> and daclatasvir has may result in an increased risk for serious slowing of the heart rate.<sup id="cite_ref-Daklinza_FDA_label_4-12" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacology">Pharmacology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=4" title="Edit section: Pharmacology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="The_role_of_NS5A_in_HCV_replication">The role of NS5A in HCV replication</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=5" title="Edit section: The role of NS5A in HCV replication"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/NS5A_(Hepacivirus)" class="mw-redirect" title="NS5A (Hepacivirus)">NS5A</a> is a <a href="/wiki/Zinc_finger" title="Zinc finger">zinc-binding protein</a> <a href="/wiki/Dimer_(chemistry)" class="mw-redirect" title="Dimer (chemistry)">dimer</a> serving as a regulator in the replication cycle of HCV. It contains an amino-terminal amphipathic helix and three different domains with different binding affinities. The N-terminus binds to cellular membranes and is essential for the formation of replication complexes. Domain 1 (amino acid 401–60012) is an RNA binding region of NS5A and domain 2 serves in the RNA replication. Virus assembly is associated with domain 3.<sup id="cite_ref-pmid21593584_13-0" class="reference"><a href="#cite_note-pmid21593584-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>NS5A not only binds to cellular membranes, other non-structural proteins of the HCV replication-complex and viral RNA, but also to co-factors like <a href="/wiki/PI4KA" title="PI4KA">PI4KA</a>. PI4KA is a kinase, which phosphorylates a hydroxyl group of phosphatidylinositol in its inositol-ring at position four. This <a href="/wiki/Phosphorylation" title="Phosphorylation">phosphorylation</a> generates phosphatidylinositol 4-phosphate (<a href="/wiki/Phosphatidylinositol_4-phosphate" title="Phosphatidylinositol 4-phosphate">PI4P</a>), a docking site normally located at the <a href="/wiki/Golgi_apparatus" title="Golgi apparatus">Golgi</a> membrane. PI4P is necessary for the recruitment of effector proteins participating in transport vesicles of lipid transfer. Resulting from that PI4P is crucial for maintaining the Golgi membrane structure and Golgi-secretion.<sup id="cite_ref-pmid30193094_14-0" class="reference"><a href="#cite_note-pmid30193094-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>By binding PI4KA on its domain 1 and accumulating PI4P away from the Golgi apparatus, NS5A induces the formation of a membranous web, a membrane structure arising from the endoplasmic reticulum via recruitment of lipid vesicles. The replication complex of HCV is located on this web-like structure. Out of these membranes and lipid drops, which had been recruited via PI4P, the <a href="/wiki/Virus" title="Virus">virions</a> can be assembled after viral-RNA replication.<sup id="cite_ref-pmid23202467_15-0" class="reference"><a href="#cite_note-pmid23202467-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>The RNA replication and assembly of virions depend on the ratio between two different forms of NS5A. Depending on the phosphorylation rate of NS5A, it is differentiated between NS5A (p56) and the hyperphosphorylated NS5A (p58). A higher rate of p58 seems to induce HCV assembly, whereas a lack of p58 leads to RNA replication. But the actual role of phosphorylation of NS5A is not clear.<sup id="cite_ref-Pawlotsky2013_16-0" class="reference"><a href="#cite_note-Pawlotsky2013-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Chukkapalli2015_17-0" class="reference"><a href="#cite_note-Chukkapalli2015-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>However, NS5A does not only regulate HCV replication and assembly, it also inhibits apoptosis, so the infected cell cannot disintegrate by itself and contain the infection, as cells normally do. Because of the lack of apoptosis, mutations within the cellular genome also do not trigger cells death. This causes the promotion of tumours.<sup id="cite_ref-Pawlotsky2013_16-1" class="reference"><a href="#cite_note-Pawlotsky2013-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Mechanism_of_action">Mechanism of action</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=6" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>NS5A contains a binding pocket in domain 1, where daclatasvir can insert. Because of the symmetric and amino acid related structure of daclatasvir, it comes to H-bond interactions between daclatasvir and the amino acids of the binding pocket. That causes a structural modification of NS5A, leading to a loss of action and resulting in an inhibition of virion formation.<sup id="cite_ref-Belema2014_18-0" class="reference"><a href="#cite_note-Belema2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>By altering the structure of NS5A, the recruitment of PI4KA and therefore the accumulation of PI4P get disabled. New lipid-drops and membranous components can no longer get recruited by PI4P in the membranous web and the web can no longer maintain. But it is important to mention that daclatasvir does not inhibit PI4KA directly, because it was observed that in cells, which were treated with daclatasvir, PI4P is still present in the plasma membrane and Golgi apparatus. Daclatasvir also does not inhibit the initial PI4KA delocalization induced by NS5A because it was witnessed that daclatasvir had no impact on the function of NS5A within cells expressing only NS5A. It is likely that daclatasvir merely inhibits functions of NS5A associated with other proteins within the HCV replication complex just like the RNA-replicase NS4B. Concluding, daclatasvir presumably only inhibits PI4P hyper-accumulation in the context of full HCV polypeptide expression.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2023)">citation needed</span></a></i>]</sup> </p><p>This phenomenon is associated with the structure of domain 1 of NS5A. It was observed that domain 1 has two different conformations. Daclatasvir binds to one of these and as a result, locks domain 1 in this conformation. Though, NS5A is still able to bind PI4KA, what can explain the remaining function of NS5A in uninfected cells mentioned before. The second conformation of domain 1, which appears in non-treated cells, is then most likely to be associated with PI4P hyper-accumulation that is necessary for the formation and maintainment of the replication-complex and membranous web. So, PI4KA can still interact with NS5A, but due to the structural blockade, NS5A is not able to activate PI4KA as efficiently as normal.<sup id="cite_ref-Chukkapalli2015_17-1" class="reference"><a href="#cite_note-Chukkapalli2015-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>The inhibition of hyper-accumulation of PI4P results in the collapse of the membranous web and the formation of large aggregated structures formed out of the proteins of the replication complex. Moreover, NS5A seems to delocalize from the membranous web to lipid drops within the cytosol.<sup id="cite_ref-Pawlotsky2013_16-2" class="reference"><a href="#cite_note-Pawlotsky2013-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Resulting from this observation, it is likely that the HCV replication-complex and virion hulls still get formed but are highly impaired by the treatment with daclatasvir.<sup id="cite_ref-Chukkapalli2015_17-2" class="reference"><a href="#cite_note-Chukkapalli2015-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Furthermore, it has been observed, that the treatment of HCV infected cells with daclatasvir leads to a lack of the hyper-phosphorylated form of NS5A (p58). It is not clear if the formation of p58 is directly inhibited by daclatasvir or if it is just a side effect. But it is likely that the lack of p58 is crucial for the inhibition of virion assembly.<sup id="cite_ref-Chukkapalli2015_17-3" class="reference"><a href="#cite_note-Chukkapalli2015-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Pharmacokinetics">Pharmacokinetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=7" title="Edit section: Pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Daclatasvir reaches <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">steady state</a> in human subjects after about 4 days of once-daily 60 mg oral administration, with a peak dose in concentration occurring about 2 hours after administration.<sup id="cite_ref-Daklinza_FDA_label_4-13" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It comes in the form of an oral tablet, with a <a href="/wiki/Bioavailability" title="Bioavailability">bioavailability</a> of 67%.<sup id="cite_ref-Daklinza_FDA_label_4-14" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Daclatasvir is predominantly metabolized by the liver enzyme <a href="/wiki/CYP3A4" title="CYP3A4">CYP3A4</a>, and is also a <a href="/wiki/P-glycoprotein" title="P-glycoprotein">P-gp substrate</a>.<sup id="cite_ref-Daklinza_FDA_label_4-15" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It is highly <a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">protein bound</a>. Protein binding was measured to be around 99% in people dosed multiple times with daclatasvir independent of dose strength.<sup id="cite_ref-Daklinza_FDA_label_4-16" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Daclatasvir has a <a href="/wiki/Volume_of_distribution" title="Volume of distribution">volume of distribution</a> of 47L following an oral dose of 60 mg and an IV dose of 100 μg.<sup id="cite_ref-Daklinza_FDA_label_4-17" class="reference"><a href="#cite_note-Daklinza_FDA_label-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=8" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Discovery_and_development_of_NS5A_inhibitors" title="Discovery and development of NS5A inhibitors">Discovery and development of NS5A inhibitors</a></div> <p>Daklinza was <a href="/wiki/Drug_discovery" title="Drug discovery">discovered</a> by scientists at <a href="/wiki/Bristol-Myers_Squibb" class="mw-redirect" title="Bristol-Myers Squibb">Bristol-Myers Squibb</a> (BMS); the precursor was identified using <a href="/wiki/Phenotypic_screening" title="Phenotypic screening">phenotypic screening</a> in which the GT-1b replicon system was implemented in <a href="/wiki/Huh7" title="Huh7">Huh7</a> cells and <a href="/wiki/Bovine_virus_diarrhea#Virus_classification_and_structure" class="mw-redirect" title="Bovine virus diarrhea">bovine viral diarrhea virus</a> also in Huh7 cells was used as a counterscreen for specificity.<sup id="cite_ref-Belema2014_18-1" class="reference"><a href="#cite_note-Belema2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Bristol Myers Squibb also <a href="/wiki/Drug_development" title="Drug development">developed</a> the drug, with the first Phase I trial publishing in 2010.<sup id="cite_ref-Belema2014_18-2" class="reference"><a href="#cite_note-Belema2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>It was approved for use in Europe in August 2014, in the US in July 2015, and in India in December 2015; it was first in the class of <a href="/wiki/NS5A_(Hepacivirus)" class="mw-redirect" title="NS5A (Hepacivirus)">NS5A</a> inhibitors to reach the market.<sup id="cite_ref-amFAR_6-1" class="reference"><a href="#cite_note-amFAR-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Synthesis">Synthesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=9" title="Edit section: Synthesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The daclatasvir molecule contains the two amino acids <a href="/wiki/Proline" title="Proline">proline</a> and <a href="/wiki/Valine" title="Valine">valine</a> in their natural <small>L</small>-form which makes it easier to synthesize in the right stereo configuration.<sup id="cite_ref-Belema2014_18-3" class="reference"><a href="#cite_note-Belema2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The following describes one exemplary mechanism of synthesizing daclatasvir as its free base. The first step is a <a href="/wiki/Friedel%E2%80%93Crafts_reaction" title="Friedel–Crafts reaction">Friedel-Crafts acylation</a> of <a href="/wiki/Biphenyl" title="Biphenyl">biphenyl</a> with chloroacetyl chloride and aluminium chloride used as a catalyst. As biphenyl is a solid crystal it is solved in <a href="/wiki/1,2-dichloroethane" class="mw-redirect" title="1,2-dichloroethane">1,2-dichloroethane</a> (DCE). The mixture of chloroacetyl chloride and aluminium chloride is also used in a solution with DCE. To separate the product from the other compounds the outcoming reaction mixture is treated with 2N HCl solution.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2023)">citation needed</span></a></i>]</sup> </p><p>In the next step, the symmetrically acetylated product from the first step reacts with an N-methoxycarbonyl dipeptide in an <a href="/wiki/Ester" title="Ester">esterification reaction</a>. The dipeptide consists of the amino acids <small>L</small>-proline and <small>L</small>-valine and is solved in acetonitrile (MeCN). While the amino terminus of valine is protected by the methoxycarbonyl group the carboxy terminus of proline reacts with the product of step one forming the esterified product of both chemicals. In this reaction <a href="/wiki/Triethylamine" title="Triethylamine">triethylamine</a> works as a basic solvent.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2021)">citation needed</span></a></i>]</sup> </p><p>As a final step, the present molecule reacts with <a href="/wiki/Ammonium_acetate" title="Ammonium acetate">ammonium acetate</a> in water forming the imidazole heterocycles on both sides of the molecule.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>Another option is to esterify it with boc-protected proline first, then form the imidazole heterocycles with ammonium acetate and add valine in the end after acidic deprotection of prolines N-terminus. In both cases, the final product is the daclatasvir free base. In the drug, daclatasvir is present in the hydrochloride salt form.<sup id="cite_ref-Belema2014_18-4" class="reference"><a href="#cite_note-Belema2014-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=10" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is on the <a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">World Health Organization's List of Essential Medicines</a>.<sup id="cite_ref-WHO23rd_7-1" class="reference"><a href="#cite_note-WHO23rd-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Economics">Economics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=11" title="Edit section: Economics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In December 2014, Bristol Myers Squibb announced that it would offer the drug for sale at different prices in different countries, depending on the level of economic development, and that it would license the drug to generics manufacturers for sale in the developing world.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p><p>As of January 2016, a twelve-week course cost around $63,000 in the US, around $39,000 in the UK, around $37,000 in France, and $525 in Egypt.<sup id="cite_ref-2016Pricing_22-0" class="reference"><a href="#cite_note-2016Pricing-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=12" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Daclatasvir has been tested in combination regimens with <a href="/wiki/Pegylated_interferon" title="Pegylated interferon">pegylated interferon</a> and <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>,<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> as well as with other direct-acting antiviral agents including <a href="/wiki/Asunaprevir" title="Asunaprevir">asunaprevir</a> and <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Daclatasvir&action=edit&section=13" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" 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Retrieved <span class="nowrap">7 April</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Health+Canada&rft.atitle=Health+Canada+New+Drug+Authorizations%3A+2015+Highlights&rft.date=2016-05-04&rft_id=https%3A%2F%2Fwww.canada.ca%2Fen%2Fhealth-canada%2Fservices%2Fpublications%2Fdrugs-health-products%2Fhealth-canada-new-drug-authorizations-2015-highlights.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADaclatasvir" class="Z3988"></span></span> </li> <li id="cite_note-UKlabel-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-UKlabel_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-UKlabel_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-UKlabel_3-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-UKlabel_3-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.medicines.org.uk/emc/medicine/29129">"Daklinza film-coated tablets – Summary of Product Characteristics (SPC) - (eMC)"</a>. Electronic Medicines Compendium. September 2016. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20161109153440/https://www.medicines.org.uk/emc/medicine/29129">Archived</a> from the original on 2016-11-09.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Daklinza+film-coated+tablets+%E2%80%93+Summary+of+Product+Characteristics+%28SPC%29+-+%28eMC%29&rft.pub=Electronic+Medicines+Compendium&rft.date=2016-09&rft_id=https%3A%2F%2Fwww.medicines.org.uk%2Femc%2Fmedicine%2F29129&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADaclatasvir" class="Z3988"></span></span> </li> <li id="cite_note-Daklinza_FDA_label-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-Daklinza_FDA_label_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Daklinza_FDA_label_4-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=433227">"Daklinza (daclatasvir) tablets, for oral useInitial U.S. Approval: 2015"</a>. <i>DailyMed</i>. 16 October 2019<span class="reference-accessdate">. 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=Daclatasvir+plus+sofosbuvir+for+previously+treated+or+untreated+chronic+HCV+infection&rft.volume=370&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E211-%3C%2Fspan%3E21&rft.date=2014-01&rft_id=info%3Adoi%2F10.1056%2FNEJMoa1306218&rft_id=info%3Apmid%2F24428467&rft.aulast=Sulkowski&rft.aufirst=MS&rft.au=Gardiner%2C+DF&rft.au=Rodriguez-Torres%2C+M&rft.au=Reddy%2C+KR&rft.au=Hassanein%2C+T&rft.au=Jacobson%2C+I&rft.au=Lawitz%2C+E&rft.au=Lok%2C+AS&rft.au=Hinestrosa%2C+F&rft.au=Thuluvath%2C+PJ&rft.au=Schwartz%2C+H&rft.au=Nelson%2C+DR&rft.au=Everson%2C+GT&rft.au=Eley%2C+T&rft.au=Wind-Rotolo%2C+M&rft.au=Huang%2C+SP&rft.au=Gao%2C+M&rft.au=Hernandez%2C+D&rft.au=McPhee%2C+F&rft.au=Sherman%2C+D&rft.au=Hindes%2C+R&rft.au=Symonds%2C+W&rft.au=Pasquinelli%2C+C&rft.au=Grasela%2C+DM&rft_id=https%3A%2F%2Fdoi.org%2F10.1056%252FNEJMoa1306218&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADaclatasvir" 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style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output 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id="RNA_virus_antivirals_(primarily_J05,_also_S01AD_and_D06BB)555" style="font-size:114%;margin:0 4em"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a> <a href="/wiki/Antiviral_drug" title="Antiviral drug">antivirals</a> (primarily <a href="/wiki/ATC_code_J05" title="ATC code J05">J05</a>, also <a href="/wiki/ATC_code_S01#S01AD" title="ATC code S01">S01AD</a> and <a href="/wiki/ATC_code_D06#D06BB" title="ATC code D06">D06BB</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hepatitis_C" title="Hepatitis C">Hepatitis C</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS3_(HCV)" class="mw-redirect" title="NS3 (HCV)">NS3</a>/<a href="/wiki/NS4A" class="mw-redirect" title="NS4A">4A</a> protease inhibitors (–previr)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Asunaprevir" title="Asunaprevir">Asunaprevir</a></li> <li><a href="/wiki/Boceprevir" title="Boceprevir">Boceprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Ciluprevir" title="Ciluprevir">Ciluprevir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Danoprevir" title="Danoprevir">Danoprevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Faldaprevir" title="Faldaprevir">Faldaprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Glecaprevir" title="Glecaprevir">Glecaprevir</a></li> <li><a href="/wiki/Grazoprevir" title="Grazoprevir">Grazoprevir</a></li> <li><a href="/wiki/Narlaprevir" title="Narlaprevir">Narlaprevir</a></li> <li><a href="/wiki/Paritaprevir" title="Paritaprevir">Paritaprevir</a></li> <li><a href="/wiki/Simeprevir" title="Simeprevir">Simeprevir</a></li> <li><a href="/wiki/Sovaprevir" title="Sovaprevir">Sovaprevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Telaprevir" title="Telaprevir">Telaprevir</a><sup><b>‡</b></sup></li> <li><a href="/wiki/Vaniprevir" title="Vaniprevir">Vaniprevir</a></li> <li><a href="/w/index.php?title=Vedroprevir&action=edit&redlink=1" class="new" title="Vedroprevir (page does not exist)">Vedroprevir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Voxilaprevir" title="Voxilaprevir">Voxilaprevir</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS5A" class="mw-redirect" title="NS5A">NS5A</a> inhibitors (–asvir)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Coblopasvir" title="Coblopasvir">Coblopasvir</a></li> <li><a class="mw-selflink selflink">Daclatasvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Elbasvir" title="Elbasvir">Elbasvir</a></li> <li><a href="/wiki/Ledipasvir" title="Ledipasvir">Ledipasvir</a></li> <li><a href="/wiki/Odalasvir" title="Odalasvir">Odalasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Ombitasvir" title="Ombitasvir">Ombitasvir</a></li> <li><a href="/wiki/Pibrentasvir" title="Pibrentasvir">Pibrentasvir</a></li> <li><a href="/wiki/Ravidasvir" title="Ravidasvir">Ravidasvir</a><sup><b>†</b></sup></li> <li><a href="/w/index.php?title=Ruzasvir&action=edit&redlink=1" class="new" title="Ruzasvir (page does not exist)">Ruzasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Samatasvir" title="Samatasvir">Samatasvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Velpatasvir" title="Velpatasvir">Velpatasvir</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/NS5B" class="mw-redirect" title="NS5B">NS5B</a> <a href="/wiki/RNA_polymerase" title="RNA polymerase">RNA polymerase</a> inhibitors (–buvir)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Beclabuvir" title="Beclabuvir">Beclabuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Bemnifosbuvir" title="Bemnifosbuvir">Bemnifosbuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Dasabuvir" title="Dasabuvir">Dasabuvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Deleobuvir" title="Deleobuvir">Deleobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Filibuvir" title="Filibuvir">Filibuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/GS-6620" title="GS-6620">GS-6620</a><sup><b>§</b></sup></li> <li><a href="/wiki/IDX-184" title="IDX-184">IDX-184</a><sup><b>§</b></sup></li> <li><a href="/wiki/Setrobuvir" title="Setrobuvir">Setrobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/Sofosbuvir" title="Sofosbuvir">Sofosbuvir</a><sup><b>#</b></sup></li> <li><a href="/w/index.php?title=Tegobuvir&action=edit&redlink=1" class="new" title="Tegobuvir (page does not exist)">Tegobuvir</a><sup><b>§</b></sup></li> <li><a href="/wiki/TMC-647055" title="TMC-647055">TMC-647055</a><sup><b>§</b></sup></li> <li><a href="/wiki/Radalbuvir" title="Radalbuvir">Radalbuvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Uprifosbuvir" title="Uprifosbuvir">Uprifosbuvir</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combination drugs</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Elbasvir/grazoprevir" title="Elbasvir/grazoprevir">Elbasvir/grazoprevir</a></li> <li><a href="/wiki/Glecaprevir/pibrentasvir" title="Glecaprevir/pibrentasvir">Glecaprevir/pibrentasvir</a></li> <li><a href="/wiki/Ledipasvir/sofosbuvir" title="Ledipasvir/sofosbuvir">Ledipasvir/sofosbuvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Ombitasvir/paritaprevir/ritonavir" title="Ombitasvir/paritaprevir/ritonavir">Ombitasvir/paritaprevir/ritonavir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Sofosbuvir/daclatasvir" title="Sofosbuvir/daclatasvir">Sofosbuvir/daclatasvir</a></li> <li><a href="/wiki/Sofosbuvir/velpatasvir" title="Sofosbuvir/velpatasvir">Sofosbuvir/velpatasvir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Sofosbuvir/velpatasvir/voxilaprevir" title="Sofosbuvir/velpatasvir/voxilaprevir">Sofosbuvir/velpatasvir/voxilaprevir</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hepatitis_D" title="Hepatitis D">Hepatitis D</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bulevirtide" title="Bulevirtide">Bulevirtide</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Picornavirus" title="Picornavirus">Picornavirus</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Viral_entry" title="Viral entry">viral entry</a>:</i> <a href="/wiki/Pleconaril" title="Pleconaril">Pleconaril</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Anti-<a href="/wiki/Influenza" title="Influenza">influenza</a> agents</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Baloxavir_marboxil" title="Baloxavir marboxil">Baloxavir marboxil</a></li> <li><a href="/wiki/Pimodivir" title="Pimodivir">Pimodivir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Umifenovir" title="Umifenovir">Umifenovir</a></li></ul> <ul><li><i><a href="/wiki/Adamantane" title="Adamantane">adamantane derivatives</a>/<a href="/wiki/M2_protein" class="mw-redirect" title="M2 protein">M2 inhibitors</a></i> (<a href="/wiki/Adapromine" title="Adapromine">Adapromine</a></li> <li><a href="/wiki/Amantadine" title="Amantadine">Amantadine</a></li> <li><a href="/wiki/Rimantadine" title="Rimantadine">Rimantadine</a>)</li></ul> <ul><li><i><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">neuraminidase inhibitors</a>/<a href="/wiki/Antiviral_drug#Release_phase" title="Antiviral drug">release phase</a></i> (<a href="/wiki/Oseltamivir" title="Oseltamivir">Oseltamivir</a><sup><b>#</b></sup></li> <li><a href="/wiki/Zanamivir" title="Zanamivir">Zanamivir</a></li> <li><a href="/wiki/Peramivir" title="Peramivir">Peramivir</a>, <a href="/wiki/Laninamivir" title="Laninamivir">Laninamivir</a><sup><b>†</b></sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Multiple/general</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Interferon" title="Interferon">Interferon</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Interferon_alfa_2b" class="mw-redirect" title="Interferon alfa 2b">Interferon alfa 2b</a></li> <li><a href="/wiki/Peginterferon_alfa-2a" title="Peginterferon alfa-2a">Peginterferon alfa-2a</a><sup><b>#</b></sup></li> <li><a href="/wiki/Peginterferon_alfa-2b" title="Peginterferon alfa-2b">Peginterferon alfa-2b</a><sup><b>#</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/3C-like_protease" title="3C-like protease">3CL protease</a> inhibitors (–trelvir)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Atilotrelvir" title="Atilotrelvir">Atilotrelvir</a></li> <li><a href="/wiki/Ensitrelvir" title="Ensitrelvir">Ensitrelvir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Ibuzatrelvir" title="Ibuzatrelvir">Ibuzatrelvir</a></li> <li><a href="/wiki/Leritrelvir" title="Leritrelvir">Leritrelvir</a></li> <li><a href="/wiki/Lufotrelvir" title="Lufotrelvir">Lufotrelvir</a></li> <li><a href="/wiki/Nirmatrelvir" title="Nirmatrelvir">Nirmatrelvir</a><sup><b>†</b></sup> (<a href="/wiki/Nirmatrelvir/ritonavir" title="Nirmatrelvir/ritonavir">+ritonavir</a>)<sup><b>†</b></sup></li> <li><a href="/wiki/Rupintrivir" title="Rupintrivir">Rupintrivir</a></li> <li><a href="/wiki/Simnotrelvir" class="mw-redirect" title="Simnotrelvir">Simnotrelvir</a> (<a href="/wiki/Simnotrelvir/ritonavir" title="Simnotrelvir/ritonavir">+ritonavir</a><sup><b>†</b></sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">RNA pol inhibitors</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CMX521" title="CMX521">CMX521</a><sup><b>§</b></sup></li> <li><a href="/wiki/Deuremidevir" title="Deuremidevir">Deuremidevir</a><sup><b>†</b></sup></li> <li><a href="/wiki/Favipiravir" title="Favipiravir">Favipiravir</a></li> <li><a href="/wiki/Galidesivir" title="Galidesivir">Galidesivir</a><sup><b>†</b></sup></li> <li><a href="/wiki/GS-441524" title="GS-441524">GS-441524</a><sup><b>§</b></sup></li> <li><a href="/wiki/Remdesivir" title="Remdesivir">Remdesivir</a></li> <li><a href="/wiki/MK-608" title="MK-608">MK-608</a><sup><b>§</b></sup></li> <li><a href="/wiki/Mericitabine" title="Mericitabine">Mericitabine</a><sup><b>†</b></sup></li> <li><a href="/wiki/Molnupiravir" title="Molnupiravir">Molnupiravir</a></li> <li><a href="/wiki/NITD008" title="NITD008">NITD008</a><sup><b>§</b></sup></li> <li><a href="/wiki/Ribavirin" title="Ribavirin">Ribavirin</a><sup><b>#</b></sup></li> <li><a href="/wiki/Taribavirin" title="Taribavirin">Taribavirin</a><sup><b>†</b></sup></li> <li><a href="/wiki/Triazavirin" class="mw-redirect" title="Triazavirin">Triazavirin</a></li> <li><a href="/wiki/Valopicitabine" title="Valopicitabine">Valopicitabine</a><sup><b>†</b></sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Multiple/Unknown/Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/EICAR_(antiviral)" title="EICAR (antiviral)">EICAR</a><sup><b>§</b></sup></li> <li><a href="/wiki/Merimepodib" title="Merimepodib">Merimepodib</a><sup><b>§</b></sup></li> <li><a href="/wiki/Moroxydine" title="Moroxydine">Moroxydine</a></li> <li><a href="/wiki/Presatovir" title="Presatovir">Presatovir</a><sup><b>†</b></sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td 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