Daclatasvir Dihydrochloride and Selegiline Hydrochloride

• Generic Name: daclatasvir
• Dosage Forms: n.a.
• Other Brand Names: Daklinza

Treatment of chronic HCV genotype 1 or genotype 3 infection in treatment-naive (previously untreated) or previously treated adults, including those with cirrhosis (compensated or decompensated), liver transplant recipients, and those with HIV coinfection.

Treatment of chronic HCV genotype 2 or genotype 4 infection; only limited data available.

Must be used in conjunction with other antivirals; do not use alone.

Usually used in a multiple-drug regimen that includes sofosbuvir (with or without ribavirin).

Efficacy of daclatasvir and sofosbuvir (with or without ribavirin) for treatment of HCV genotype 1a infection is reduced in cirrhotic patients with NS5A polymorphisms M28, Q30, L31, or Y93 at baseline. Consider screening for NS5A polymorphisms prior to initiation of treatment in cirrhotic patients with HCV genotype 1a infection. (See General under Dosage and Administration.)

Efficacy of daclatasvir and sofosbuvir (with or without ribavirin) is reduced in cirrhotic patients with HCV genotype 3 infection compared with those without cirrhosis.

Treatment of chronic HCV infection is complex and rapidly evolving; consult a specialist to obtain the most up-to-date information.

• Generic Name: selegiline
• Dosage Forms: n.a.
• Other Brand Names: Eldepryl, Zelapar, Emsam

Used as adjunctive therapy for symptomatic treatment of parkinsonian syndrome (e.g., parkinsonism, Parkinson disease [paralysis agitans]) in patients who exhibit a deteriorating response to levodopa/carbidopa; designated an orphan drug by FDA for this condition. Appears to be most beneficial when used during the early stages of the “wearing off” effect. Especially useful in improving “end-of-dose” motor fluctuations.

Has been used as monotherapy in patients with newly diagnosed parkinsonian syndrome. Because selegiline is well tolerated and possibly neuroprotective (i.e., reduces the rate of progression of parkinsonian syndrome ), some clinicians initiate therapy with selegiline in such patients, reserving levodopa or another agent (i.e., dopamine agonist) until manifestations become severe enough to warrant more aggressive therapy. However, the manufacturers state that there is no evidence from controlled studies indicating that selegiline provides benefit in the absence of concurrent levodopa therapy.

Has been used with equivocal results for the palliative treatment of mild to moderate dementia of the Alzheimer’s type (Alzheimer’s disease, presenile or senile dementia).