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Natdac
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Natdac

Natdac (Daclatasvir) is an antiviral medicine that prevents hepatitis C virus (HCV) from multiplying in your body. Natdac is used to treat genotype 1 and genotype 3 chronic hepatitis C in adults with or without cirrhosis.

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Natdac
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60mg
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Natdac
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Common use


The active ingredient present in Natdac is daclatasvir60 mg.


Natdac is a drug for the treatment of hepatitis C (HCV). Daclatasvirinhibits the HCV nonstructural protein NS5A. Recent research suggests that it targets two steps of the viral replication process, enabling rapid decline of HCV RNA. Natdac is indicated for use with sofosbuvir, with or without ribavirin, for the treatment of patients with chronic hepatitis C virus (HCV) genotype 1 or genotype 3 infections.


It is advised to avoid pregnancy during combination treatment with Natdac and sofosbuvir with ribavirin for 6 months after completion of treatment.



Dosage and direction


The recommended dosage of Natdac is 60 mg, taken orally, once daily, with or without food.


Recommended Treatment Regimen and Duration for Natdac


Genotype 1:

  • Without cirrhosis - Natdac + sofosbuvir for 12 weeks
  • Compensated (Child-Pugh A) cirrhosis - Natdac + sofosbuvir for 12 weeks
  • Decompensated (Child-Pugh B or C) cirrhosis - Natdac + sofosbuvir + ribavirin for 12 weeks
  • Post-transplant - Natdac + sofosbuvir + ribavirin for 12 weeks


Genotype 3:

  • Without cirrhosis - Natdac + sofosbuvir for 12 weeks
  • Compensated (Child-Pugh A) or decompensated (Child-Pugh B or C) cirrhosis - Natdac + sofosbuvir + ribavirin for 12 weeks
  • Post-transplant - Natdac + sofosbuvir + ribavirin for 12 weeks

For specific dosage recommendations for sofosbuvir, refer to the prescribing information.



Precautions


The concomitant use of Natdac and other drugs may result in known or potentially significant drug interactions, some of which may lead to loss of therapeutic effect of Natdac and possible development of resistance, dosage adjustments of concomitant medications or Natdac, possible clinically significant adverse reactions from greater exposures of concomitant drugs or Natdac.


Postmarketing cases of symptomatic bradycardia and cases requiring pacemaker intervention have been reported when amiodarone is coadministered with sofosbuvir in combination with another HCV direct-acting antiviral, including Natdac. A fatal cardiac arrest was reported in a patient receiving a sofosbuvir-containing regimen (ledipasvir/sofosbuvir). Bradycardia generally resolved after discontinuation of HCV treatment. The mechanism for this bradycardia effect is unknown.


For patients taking amiodarone who have no alternative treatment options and who will be coadministered Natdac and sofosbuvir need cardiac monitoring for the first 48 hours of coadministration, after which outpatient or self-monitoring of the heart rate should occur on a daily basis through at least the first 2 weeks of treatment.



Contraindications


Drugs that are Contraindicated with Natdac:

  • Anticonvulsants - phenytoin, carbamazepine
  • Antimycobacterial agents - rifampin
  • Herbal products - St. John’s wort (Hypericum perforatum)



Possible side effects


Most common side effects occurred during the trials in combination with sofosbuvir (with or without ribavirin), with peginterferon alfa/ribavirin, with asunaprevir, or with asunaprevir/peginterferon alfa/ribavirin are such: fatigue, headache, pruritus, insomnia, influenza-like illness, dry skin, nausea, decreased appetite, alopecia, rash, asthenia, irritability, myalgia, anemia, pyrexia, cough, dyspnea, neutropenia, diarrhea, arthralgia, neutropenia, anemia, thrombocytopenia, and lymphopenia.


If you take Natdac with sofosbuvir and you also take a heart rhythm medicine called amiodarone: This combination of medicines can cause dangerous side effects on your heart.



Drug interaction


Potential for Other Drugs to Affect Natdac (clinically relevant increase in concentration):

  • HIV antiviral agents - Atazanavir with ritonavirb; Indinavir; Nelfinavir; Saquinavir.
  • Other antiretrovirals - Cobicistat-containing antiretroviral regimens e.g. atazanavir/cobicistat,
    elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate.
  • Anticoagulants - Dabigatran etexilate mesylate.
  • Strong inhibitors of CYP3A (eg, clarithromycin, itraconazole, ketoconazole, ritonavir) may increase the plasma levels of daclatasvir.


Potential for Natdac to Affect Other Drugs (clinically relevant decrease in concentration):

  • Non-nucleoside reverse transcriptase inhibitors (NNRTI) - Efavirenzb; Etravirine; Nevirapine.
  • Moderate CYP3A inducers (see also HIV antiviral agents) - Examples: bosentan, dexamethasone, modafinil, nafcillin, rifapentine.


Daclatasvir is an inhibitor of P-glycoprotein transporter (P-gp), organic anion transporting polypeptide (OATP) 1B1 and 1B3, and breast cancer resistance protein (BCRP). Administration of Natdac may increase systemic exposure to medicinal products that are substrates of P-gp, OATP 1B1 or 1B3, or BCRP, which could increase or prolong their therapeutic effect or adverse reactions.



Missed dose


Take Natdac every day at the regularly scheduled time with or without food. It is important not to miss or skip doses and to take Natdac for the duration that is recommended by the physician. For instructions for missed doses of other agents in the regimen, refer to the respective prescribing information.



Overdose


There is no known antidote for overdose of Natdac. Treatment of overdose with Natdac should consist of general supportive measures, including monitoring of vital signs and observation of the patient’s clinical status. Because daclatasvir is highly protein bound (>99%), dialysis is unlikely to significantly reduce plasma concentrations of the drug.



Storage


Store Natdac tablets at 25°C (77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Store away from moisture and heat. Keep all drugs out of the reach children and pets.



Disclaimer


We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.