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Review
. 2025 Feb;45(2):e16177.
doi: 10.1111/liv.16177.

Drug-Drug Interactions Between DAAs and Anticoagulants or Antiplatelets: A Position Paper of the Italian Anticoagulation Clinics

Elisabetta Tombolini  1 , Alessandro Squizzato  2   3 , Gian Marco Podda  4 , Alessio Aghemo  5   6 , Nicola Ferri  7 , Simone Segato  8 , Daniela Poli  9 , Marco Paolo Donadini  1   2
Affiliations
Review

Drug-Drug Interactions Between DAAs and Anticoagulants or Antiplatelets: A Position Paper of the Italian Anticoagulation Clinics

Elisabetta Tombolini et al. Liver Int. 2025 Feb.

Abstract

The natural history of chronic hepatitis C virus (HCV) infection has changed after the introduction of direct-acting antiviral agents (DAAs). Screening programs have been ongoing to reach the World Health Organisation's goal of HCV elimination by 2030, and most infected people are eligible for treatment. Given the increased cardiovascular risk in people with HCV infection and the metabolic pathways of DAAs, it is not uncommon to face the issue of drug-drug interactions (DDIs) with antiplatelet or anticoagulant drugs. In the absence of clinical trials, we offer suggestions to deal with DDIs in case of treatment of patients with DAAs who are also receiving antiplatelet or anticoagulant drugs, based on the best available evidence from pharmacodynamics and pharmacokinetics studies in conjunction with clinical experience in the field of haemostasis and thrombosis.

Keywords: DOAC; anticoagulants; antiviral agents; drug interactions; hepatitis C.

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References

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