Multidisciplinary Approach to Drug-Drug Interactions between Tacrolimus and Sofosbuvir/Velpatasvir and Glecaprevir/Pibrentasvir in Kidney Transplant Patients during Hepatitis C Treatment: A Case Series Report

The direct acting antivirals (DAAs) are now the standard of care for hepatitis C virus (HCV) treatment with high and effective sustained virologic responserate (SVR) and great safety profile, including solid organ transplant patients. There are increasing reports showing DAAs are effective with high SVR rates and safety profile in kidney transplant recipients. There are reports on drug-drug interaction (DDI) between tacrolimus with DAAs. However, data remain lacking on potential DDIs between tacrolimus and DAA regimens and the management process. This case series reports three kidney transplant patients on tacrolimus who were successfully treated for HCV with multidisciplinary approach, although there was DDI between tacrolimus with sofosbuvir/velpatasvir and glecaprevir/pibrentasvir, which required tacrolimus dose adjustment to maintain therapeutic level during and after DAA treatment. Such DDIs should be aware of and closely monitored by pharmacist and physicians with tacrolimus dose adjustment as needed during and right after DAA treatment in post-kidney transplant patients.