{"id":52301,"date":"2023-09-20T09:31:48","date_gmt":"2023-09-20T09:31:48","guid":{"rendered":"https:\/\/medsname.com\/natdac\/"},"modified":"2026-05-05T05:21:56","modified_gmt":"2026-05-05T05:21:56","slug":"natdac","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/natdac\/","title":{"rendered":"Natdac"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">R\u0103spuns rapid<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Natdac<\/strong> \u2014 daclatasvir 30\/60 mg (Natco Pharma). Inhibitor pan-genotipic NS5A \u2014 utilizat \u00een combina\u021bie cu sofosbuvir pentru vindecarea hepatitei C la toate genotipurile 1-6, \u00een special genotipul 3, unde r\u0103m\u00e2ne preferat. Genericul lui BMS Daklinza.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Ce beneficii ofer\u0103 MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>produc\u0103tor certificat WHO-GMP<\/li>\n<li>Ambalaj discret \u00een plic simplu<\/li>\n<li>Livrare \u00een toat\u0103 lumea<\/li>\n<li>Evaluat de peste 1.400 de clien\u021bi (<a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">cite\u0219te recenziile<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Garan\u021bia de retransmitere:<\/strong> dac\u0103 comanda dvs. nu a ajuns \u00een 20 de zile lucr\u0103toare de la expediere, o retransmitem f\u0103r\u0103 costuri suplimentare. <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Cite\u0219te politica<\/a>.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Natdac este expediat de la un produc\u0103tor certificat WHO-GMP \u00een ambalaj simplu, facturat prin intermediul unui procesor de pl\u0103\u021bi reglementat (descrierea extrasului de cont indic\u0103 un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 MedsBase sau numele vreunui medicament). Fiecare comand\u0103 beneficiaz\u0103 de Asigurarea noastr\u0103 de Reexpediere \u00een 20 de zile lucr\u0103toare.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Avertizare FDA: reactivare HBV<\/strong><br \/>Toate terapiile DAA pentru hepatita C poart\u0103 o avertizare FDA privind reactivarea virusului hepatitei B la pacien\u021bii cu infec\u021bie mixt\u0103 HCV + HBV (care poate fi fulminant\u0103 \u0219i fatal\u0103). Testa\u021bi HBsAg \u0219i ADN HBV \u00eenainte de a \u00eencepe orice regim DAA. Dac\u0103 HBV-pozitiv, hepatologul trebuie s\u0103 gestioneze cotratamentul sau terapia profilactic\u0103 anti-HBV.<\/div>\n<h2>Cum func\u021bioneaz\u0103 daclatasvirul<\/h2>\n<p>NS5A este o protein\u0103 multifunc\u021bional\u0103 a VHC esen\u021bial\u0103 pentru replicarea ARN-ului viral \u0219i asamblarea viral\u0103. Daclatasvirul se leag\u0103 de NS5A \u0219i perturb\u0103 at\u00e2t formarea complexului de replicare, c\u00e2t \u0219i asamblarea virionului. Este potent, pan-genotipic \u0219i bine tolerat.<\/p>\n<p>Daclatasvirul este \u00eentotdeauna administrat cu sofosbuvir (sau alt\u0103 baz\u0103 de nucleotid\u0103) \u2014 niciodat\u0103 ca monoterapie. Combina\u021bia ob\u021bine RVS12 la \u226595% din pacien\u021bi la toate genotipurile, inclusiv genotipul 3 (unde regimurile bazate pe ledipasvir sunt mai slabe).<\/p>\n<p>Doza standard este de 60 mg o dat\u0103 pe zi. Reduce\u021bi la 30 mg cu inhibitori puternici ai CYP3A4; cre\u0219te\u021bi la 90 mg cu inductori moderati (c\u00e2nd este inevitabil).<\/p>\n<h2>Tabel cu durata tratamentului<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Popula\u021bie<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">Regim<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Genotipul 1 \/ 4 \/ 5 \/ 6, tratament naiv, f\u0103r\u0103 ciroz\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni (de obicei combinat cu un inhibitor NS5A)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Genotipul 2, f\u0103r\u0103 ciroz\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni (sofosbuvir + ribavirin\u0103 sau sofosbuvir + daclatasvir)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Genotipul 3, f\u0103r\u0103 ciroz\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni sofosbuvir + daclatasvir (sofosbuvir + velpatasvir este o alternativ\u0103 pan-genotipic\u0103)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Ciroz\u0103 compensat\u0103 (orice genotip)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">12 s\u0103pt\u0103m\u00e2ni combina\u021bie DAA + ribavirin\u0103 \u00een cazuri selectate; 24 de s\u0103pt\u0103m\u00e2ni dac\u0103 pacientul a mai fost tratat anterior<\/td>\n<\/tr>\n<\/table>\n<p>R\u0103spunsul virologic sus\u021binut la 12 s\u0103pt\u0103m\u00e2ni post-tratament (SVR12) este markerul vindec\u0103rii \u2014 ob\u021binut \u00een ~95-99% din pacien\u021bi cu regimuri moderne de DAA.<\/p>\n<h2>Interac\u021biuni medicamentoase importante<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Medicament<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">Efect \u0219i ac\u021biune<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Amiodaron\u0103 + sofosbuvir<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\"><strong>Avertizare FDA \u2014 bradicardie simptomatic\u0103, cazuri de deces raportate.<\/strong> Evita\u021bi combina\u021bia. Dac\u0103 este inevitabil\u0103, este necesar monitorizarea cardiac\u0103 \u00een spital.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">PPI (omeprazol, pantoprazol)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Reduce absorb\u021bia ledipasvirului (dependent\u0103 de pH). Administra\u021bi regimurile care con\u021bin ledipasvir cu alimente \u0219i PPI la interval de \u22654 ore, sau folosi\u021bi antagoni\u0219ti H2\/antiacide \u00een loc. Velpatasvir este de asemenea sensibil la pH \u2014 aceea\u0219i recomandare.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Rifampicin\u0103, rifabutin\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Inductori puternici ai CYP3A4 + P-gp \u2014 reduc semnificativ nivelurile de DAA. Evita\u021bi combina\u021bia.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Iarba Sf\u00e2ntului Ioan<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Induc\u021bia CYP3A4 \u2014 reduce nivelurile de DAA \u0219i riscul de e\u0219ec terapeutic. Evita\u021bi pe tot parcursul terapiei.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Fenitoin\u0103, carbamazepin\u0103, oxcarbazepin\u0103<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Inductori anticonvulsivanti \u2014 reduc semnificativ nivelurile DAA. Trecerea la un antiepileptic neinduc\u0103tor (lamotrigin\u0103, levetiracetam) \u00eenainte de \u00eenceperea terapiei hepatitei C.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Statine (rosuvastatin\u0103, atorvastatin\u0103)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Cre\u0219teri variabile ale nivelurilor de statin\u0103. Utiliza\u021bi doza cea mai mic\u0103; rosuvastatina este \u00een general evitat\u0103 cu sof+vel; atorvastatina este acceptabil\u0103 la doze mici.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Warfarin<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">INR poate fluctua pe m\u0103sur\u0103 ce ficatul se recupereaz\u0103 \u00een timpul terapiei DAA. Monitoriza\u021bi INR s\u0103pt\u0103m\u00e2nal p\u00e2n\u0103 la stabilizare.<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Antiretrovirale HIV<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">Tenofovir + ledipasvir \u2014 expunere crescut\u0103 la tenofovir; monitoriza\u021bi func\u021bia renal\u0103. Efavirenz reduce nivelurile de velpatasvir \u2014 evita\u021bi combina\u021bia. Coinfec\u021bia HCV-HIV necesit\u0103 \u00eentotdeauna consult specializat ID\/hepatologie.<\/td>\n<\/tr>\n<\/table>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3>Care este rata de vindecare?<\/h3>\n<p>Regimurile moderne DAA ob\u021bin r\u0103spuns virologic sus\u021binut (SVR12) \u2014 ARN HCV nedetectabil la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament, considerat vindecare \u2014 la 95-99% din pacien\u021bi pe toate genotipurile. Ciroza, e\u0219ecul tratamentelor anterioare \u0219i coinfec\u021bia HCV\/HIV reduc u\u0219or ratele de r\u0103spuns.<\/p>\n<h3>Ce este SVR12?<\/h3>\n<p>R\u0103spuns Virologic Sus\u021binut la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament. Dup\u0103 finalizarea unui curs DAA de 12 s\u0103pt\u0103m\u00e2ni, ARN HCV este verificat la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 ultima doz\u0103. Nedetectabil = vindecare. Recidiva t\u00e2rzie dup\u0103 SVR12 este &lt;1%.<\/p>\n<h3>Voi avea nevoie de un test de urm\u0103rire?<\/h3>\n<p>Da. ARN HCV la sf\u00e2r\u0219itul tratamentului + la 12 s\u0103pt\u0103m\u00e2ni dup\u0103 tratament confirm\u0103 SVR12. Biochimia hepatic\u0103 \u0219i FibroScan\/imagistic\u0103 la 6-12 luni la pacien\u021bii cirotici pentru evaluarea regresiunii. Chiar \u0219i dup\u0103 vindecare, screening pentru carcinom hepatocelular la fiecare 6 luni dac\u0103 ciroza este stabilit\u0103.<\/p>\n<h3>Ce spune\u021bi despre hepatita B?<\/h3>\n<p>Toate DAA-urile poart\u0103 un avertisment FDA pentru reactivarea HBV la pacien\u021bii cu coinfec\u021bie HCV+HBV. Testa\u021bi HBsAg \u0219i ADN HBV \u00eenainte de \u00eencepere. Dac\u0103 HBV-pozitiv, hepatologia trebuie s\u0103 coordoneze.<\/p>\n<h3>Pot consuma alcool?<\/h3>\n<p>Evita\u021bi consumul de alcool pe tot parcursul tratamentului \u0219i, ideal, pentru 6-12 luni dup\u0103. Consumul activ de alcool nu exclude terapia cu DAA, dar \u00eenr\u0103ut\u0103\u021be\u0219te rezultatele pe termen lung ale ficatului, indiferent de starea de HCV.<\/p>\n<h3>Sarcin\u0103?<\/h3>\n<p>Sofosbuvir este clasificat de FDA \u00een categoria B de sarcin\u0103 (nu exist\u0103 date despre teratogenitate uman\u0103; datele animale sunt lini\u0219titoare). Majoritatea DAA-urilor nu au date despre sarcin\u0103. Contraceptia \u00een timpul terapiei este standard. Ribavirina (c\u00e2nd este utilizat\u0103 ca adjunct) este puternic teratogen\u0103 \u2014 ambii parteneri trebuie s\u0103 foloseasc\u0103 contraceptie \u00een timpul terapiei cu ribavirin\u0103 \u0219i 6 luni dup\u0103.<\/p>\n<h3>Efecte secundare?<\/h3>\n<p>DAA-urile moderne sunt \u00een general bine tolerate. Frecvente: oboseal\u0103, cefalee, grea\u021b\u0103, insomnie. Mai pu\u021bin frecvente: erup\u021bii cutanate, diaree. Efectele secundare care limiteaz\u0103 tratamentul sunt rare.<\/p>\n<h3>Generice vs originale \u2014 conteaz\u0103?<\/h3>\n<p>DAA-urile generice indiene sunt fabricate sub licen\u021be voluntare de la Gilead (Sovaldi, Harvoni, Epclusa), AbbVie \u0219i BMS. Sunt bioechivalente \u0219i con\u021bin aceea\u0219i molecul\u0103. Multiple studii din practic\u0103 (CT2, Plus-Asia) arat\u0103 rate SVR12 echivalente cu produsele originale.<\/p>\n<h3>Interac\u021biuni medicamentoase de urm\u0103rit?<\/h3>\n<p>Cele mai importante: amiodaron\u0103 + sofosbuvir (bradicardie cu avertizare \u00een cutie neagr\u0103), rifampicin\u0103 (scade nivelurile de DAA), PPI (reduc ledipasvir\/velpatasvir), ajust\u0103ri necesare pentru ARV HIV \u00een caz de co-infec\u021bie. Dezv\u0103lui\u021bi \u00eentotdeauna toate medicamentele, inclusiv cele pe baz\u0103 de plante\/OTC.<\/p>\n<h3>Dup\u0103 vindecare \u2014 pot s\u0103 fac din nou HCV?<\/h3>\n<p>Da. SVR elimin\u0103 infec\u021bia curent\u0103, dar nu ofer\u0103 imunitate viitoare. Re-infec\u021bia prin noi expuneri (consum de droguri intravenos, proceduri medicale nesigure, MSM cu co-infec\u021bie HIV) este posibil\u0103. Consilierea privind preven\u021bia \u0219i oferirea test\u0103rii HCV RNA la orice nou\u0103 expunere la risc.<\/p>\n<p class=\"medsbase-link-boost-2026-05-05\" data-marker=\"mb-link-boost-hepcinat-lp\"><a href=\"https:\/\/medsbase.com\/ro\/natdac\/\">Natdac<\/a> (daclatasvir 60 mg) este luat \u00eempreun\u0103 cu sofosbuvir pentru mai multe genotipuri, dar pentru genotipurile 1, 4, 5 \u0219i 6, comprimatul unic <a href=\"https:\/\/medsbase.com\/ro\/hepcinat-lp\/\">Hepcinat LP (sofosbuvir 400 mg + ledipasvir 90 mg)<\/a> consolideaz\u0103 ambele agen\u021bi \u0219i \u00eembun\u0103t\u0103\u021be\u0219te adheren\u021ba fa\u021b\u0103 de regimul zilnic cu dou\u0103 comprimate.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Alte medicamente pentru hepatita C<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/myhep\/\">MyHep<\/a> \u2014 sofosbuvir 400 mg \u2014 partener de combina\u021bie pentru daclatasvir<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hepcinat\/\">Hepcinat<\/a> \u2014 sofosbuvir 400 mg \u2014 marc\u0103 Natco<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/hepcvir\/\">Hepcvir<\/a> \u2014 sofosbuvir 400 mg \u2014 marca Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/velpanat\/\">Velpanat<\/a> \u2014 sofosbuvir + velpatasvir \u2014 alternativ\u0103 pan-genotipic\u0103 \u00eentr-un singur comprimat<\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/ledifos\/\">Ledifos<\/a> \u2014 sofosbuvir + ledipasvir pentru genotipurile 1, 4, 5, 6<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Disclaimer medical:<\/strong> Aceast\u0103 pagin\u0103 este doar informativ\u0103 \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui clinician calificat. Discuta\u021bi orice medicament nou cu medicul sau farmacistul dumneavoastr\u0103.<\/div>","protected":false},"excerpt":{"rendered":"<p>Natdac (Daclatasvir 30\/60 mg) \u2014 inhibitor pan-genotipic NS5A de la Natco pentru hepatita C cronic\u0103. Combinat cu sofosbuvir; schelet preferat pentru genotipul 3.<\/p>","protected":false},"featured_media":52302,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3334],"product_tag":[],"class_list":{"0":"post-52301","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hepatitis-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/52301","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=52301"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/52302"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=52301"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=52301"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=52301"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=52301"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}