索非布韦联合达卡他韦用药对治疗丙肝效果更好，能大幅度提到丙肝率(见本文附图1,附图2)。也就是丙肝患者常常听到的“欧盟组合”方案。但是很多患者们对此方案并不了解，也有很多患者购买此方案的疗程包后有很多疑虑，例如：如何服用？以及服用时候需要注意什么？有哪些副作用？

为了解答患者的这一系列疑问，印度塔塔药房详细的介绍这一治疗方案。希望能给更多的丙肝患者以帮助。

复方制剂DACTINNA

(Sofosbuvir 400 mg film-coated tablets, Daclatasvir 60mg film-coated tablets )

（索非布韦 400mg/片，达卡他韦 60mg/片）

复方制剂DACTINNA(Sofosbuvir+ Daclatasvir)用药须知

 Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

由于本说明有很重要的信息，请您在服用DACTINNA复方制剂之前，认真阅读。

Keep this leaflet. You may need to read it again.
请保存好本说明，以后你可能会需要再次查阅。

If you have any further questions, ask your doctor or pharmacist.
如果您还有其他的疑问，请询问您的医生。

This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
这个处方药是只针对您个人的，请不要拿给其他人服用，这样可能会对他们造成伤害，即使他是跟你一样的病情。

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
如果您服用过程中有什么副作用，请跟您的医生说明。这些副作用有可能不在本说明之列。请详细阅读本说明第四部分。

What is in this leaflet?

（这个说明包含哪些内容？）

一、What DACTINNA is and what it is used for (DACTINNA是什么并且有何用途)

二、What you need to know before you take DACTINNA (在您服用之前需要了解哪些信息)

三、How to take DACTINNA (怎样如用DACTINNA)

四、Possible side effects (可能出现的副作用)

五、 How to store DACTINNA (怎样保存DACTINNA)

 

一、What DACTINNA is and what it is used for

DACTINNA是什么以及有何用途

DACTINNA contains the active ingredient Daclatasvir 60mg (Yellow tablet) and Sofosbuvir 400mg (Red tablet). It is used to treat adults with hepatitis C, an infectious disease that affects the liver, caused by the hepatitis C virus.

DACTINNA包含活性成分Daclatasvir 60mg（黄色片剂）和Sofosbuvir 400mg（红色片剂），它主要用来治疗成年丙肝病毒感染者。

This medicine works by stopping the hepatitis C virus from multiplying and infecting new cells. This lowers the amount of hepatitis C virus in your body and removes the virus from your blood over a period of time.

这种药能够阻止丙肝病毒复制并且感染新的肝脏细胞。这种药物能够降低病毒在人体的水平并且最终能够从人体中完全清除。

It is very important that you also read the package leaflets for the other medicines that you will be taking with DACTINNA. If you have any questions about your medicines, please ask your doctor or pharmacist.

二、What you need to know before you take DACTINNA

                              在服用DACTINNA之前需要了解的信息

Do not take DACTINNA 有以下情况请不要服用DACTINNA

If you are allergic to Daclatasvir and Sofosbuvir any of the other ingredients of this medicine (listed in section 6 of this leaflet) 如果您对Daclatasvir或者Sofosbuvir过敏，或者本复方药的其他成分过敏，请马上告诉您的医生或者马上停止服用。

àIf this applies to you, tell your doctor immediately.

If you are taking (by mouth or other ways that affect the whole body) any of the following medicines

如果您服用或者注射以下药物：

-phenytoin, carbamazepine, oxcarbazepine or phenobarbital, used to treat epileptic seizures

-rifampicin, rifabutin or rifapentine, antibiotics used to treat tuberculosis

-dexamethasone, a steroid used to treat allergic and inflammatory diseases

-medicines containing St. John’s wort (Hypericum perforatum, a herbal preparation).

These medicines lower the effect of DACTINNA and may result in your treatment not working. If you take any of these medicines, tell your doctor immediately.

以上药物会降低DACTINNA复方的药血浓度并且有可能导致失效。如果您服用或者注射以上药物，请马上告诉您的医生。

Please make sure that you read the “Do not take” section of the package leaflets for these medicines. If you are unsure of any information in the package leaflets, please contact your doctor or pharmacist.

 请确保您读过本章节的内容。如果有不明确的部分，请与您的医生联系。

Warnings and precautions 警示和预防

Talk to your doctor or pharmacist before taking DACTINNA.

Tell your doctor if any of the following applies:

如果以下情形适用您，请告诉您的医生：

you have an infection with the human immunodeficiency virus (HIV) or a hepatitis B infection
如果您有HIV或者乙肝

you have had, or are waiting to have a liver or another organ transplant
如果做过肝移植，或者等待肝移植，或者其他器官移植的。

your liver is damaged and not functioning properly (decompensated liver disease)
如果您的肝脏已经处于失代偿期

Have kidney problems. Talk to your doctor or pharmacist if you have severe kidney problems or if you are on kidney dialysis as the effects of DACTINNA on patients with severe kidney problems have not been fully tested.
有严重肾病患者

Blood tests

Your doctor will test your blood before, during and after your treatment with DACTINNA.

This is so your doctor can:

Decide what other medicines you should take with DACTINNA and for how long;

Confirm that your treatment has worked and you are free of the hepatitis C virus.

 Children and adolescents 儿童和青少年

DACTINNA is not recommended for patients below 18 years of age. DACTINNA has not yet been studied in children and adolescents. 18岁以下不建议使用，本复方没有在18岁以下做过临床研究。

Other medicines and DACTINNA 其他药物和DACTINNA的关系

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This is because DACTINNA may affect the way some medicines work. In addition some medicines may affect the way DACTINNA works. Your doctor may need to adjust the dose of DACTINNA or you may not be able to take DACTINNA with certain medicines. 如果正在服用，最近服用，或者打算服用以下药物的，请告诉您的医生。因为这些药物可能会与DACTINNA复方有冲突，彼此影响效果。我们根据实际情况，需要调整您服用的剂量。

Do not take DACTINNA if you are taking any of the following medicines: 如果您正在吃以下药物，请不要服用DACTINNA:

-抗癫痫药物：

Phenytoin（苯妥英，二本乙内酰脲）, carbamazepine（立痛定，卡巴咪嗪，卡马西平）, oxcarbazepine（奥卡西平） or phenobarbital（苯巴比妥米那）

抗肺结核药物

-rifampicin（利福平）, rifabutin（利福布汀）or rifapentine（利福喷汀）

抗过敏、消炎药物

-dexamethasone（地塞米松，氟美松）

抗抑郁

-medicines containing St. John’s wort (Hypericum perforatum, a herbal preparation).（圣约翰草）

These medicines lower the effect of DACTINNA so your treatment will not work. If you take any of these medicines, tell your doctor immediately.

这些药物会影响到DACTINNA的药效，如果你服用的话，请立即告诉你的医生。

Tell your doctor if you take any of the following medicines: 如果您正在吃以下药物，请告诉您的医生：

atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir, etravirine, nevirapine, efavirenz or any medicine combined with cobicistat, used to treat HIV infection
抗艾滋病药物，阿扎那韦/利托那韦，达芦那韦/利托那韦，洛匹那韦/利托那韦，依曲韦林，奈韦拉平，依非韦伦等。

boceprevir or telaprevir, used to treat hepatitis C infection
抗丙肝的波普瑞韦，特拉匹韦。

clarithromycin, telithromycin or erythromycin, used to treat bacterial infections
抗细菌药物：克拉霉素，泰利霉素，红霉素。

dabigatran etexilate, used to to prevent blood clots
抗血栓药，达比加群脂

ketoconazole, itraconazole, posaconazole or voriconazole, used to treat fungal infections
抗真菌药：酮康唑，伊曲康唑，泊沙康唑，伏立康唑。

digoxin, used to treat irregular heart beats
医治心率不齐的地高辛。

verapamil, diltiazem, nifedipine or amlodipine, used to decrease blood pressure
降血压药：维拉帕米，地尔硫?，硝苯地平，氨氯地平。

rosuvastatin, atorvastatin, fluvastatin, simvastatin, pitavastatin or pravastatin, used to lower blood cholesterol
降血脂药：罗苏伐他汀，阿托伐他汀，氟伐他汀，辛伐他汀，匹伐他汀，普伐他汀。

oral contraceptives
口服避孕药

With some of these medicines, your doctor may need to adjust your dose of DACTINNA. 如果您正在这些药物，您的医生可能会调整您的服用剂量。。

Pregnancy and contraception 怀孕和避孕

Tell your doctor if you are pregnant, think you may be pregnant or are planning to become pregnant. If you become pregnant, stop taking DACTINNA and tell your doctor immediately.如果你已经怀孕、有可能怀孕或者计划怀孕，请告诉您的医生，并且停止服用DACTINNA。

If you are pregnant you must not take DACTINNA.
如果您已经怀孕，请停止服用DACTINNA。
If you can become pregnant, use effective contraception during and for 5 weeks after your treatment with DACTINNA. 如果您有可能怀孕，请采取有效的避孕措施一直到服用结束5周以后。
DACTINNA is sometimes used together with ribavirin. Ribavirin can harm your unborn baby. It is therefore very important that you (or your partner) do not become pregnant during this treatment.
DACTINNA有时会与利巴韦林一起使用，利巴韦林对于胎儿有影响。因此自己或者同伴必须在治疗期间避免怀孕。
You or your partner must use an effective birth control method during treatment and afterwards. It is very important that you read the “Pregnancy” section in the ribavirin package leaflet very carefully. Ask your doctor for effective contraceptive method suitable for you.
If you or your partner become pregnant during DACTINNA treatment or in the months that follow, you must contact your doctor immediately. 如果你自己或者同伴在服用期间意外怀孕了，请立即和您的医生联系，听取医生专业意见。
Breast-feeding 哺乳

It is not known whether Sofosbuvir and Daclatasvir, the active substances, pass into human breast milk. You should not breast-feed during treatment with DACTINNA.

我们还不清楚DACTINNA是否对于母乳喂养有影响，请治疗期间不要对于婴儿哺乳。

Driving and using machines驾驶或者操作机械

Some patients have reported dizziness, difficulty concentrating, and vision problems while taking DACTINNA for their hepatitis C infection. If you have any of these side effects, do not drive or use any tools or machines.

有些患者服用过程中反映有头晕，注意力难以集中，视力障碍等副作用，如果有这些现象，请不用驾驶或者操作机械。

DACTINNA contains lactose DACTINNA含有乳糖

If you have been told by your doctor that you have an intolerance to some sugars (e.g. lactose), talk to your doctor before taking DACTINNA.

如果您的医生告知你不能耐受糖分的，请在服用DACTINNA前告知你的医生。

三、How to take DACTINNA

怎样服用DACTINNA

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

请严格遵照医嘱服用本复方制剂。

Recommended dose 推荐剂量

The recommended dose is one tablet once a day of Daclatasvir 60 mg and one tablet once a day of Sofosbuvir 400mg. Swallow the tablets whole. Do not chew or crush the tablet as it has a very unpleasant taste. DACTINNA can be taken with or without a meal. 每天一次，一次各一片，吞下，不要咀嚼，否则会有不舒服的味道。随餐或不随餐服用。早餐后一小时服用效果最佳。如有服用其他药物，请前后隔开4个小时服用。

Some other medicines can interact with DACTINNA, affecting the levels of DACTINNA in your body. If you are taking any of these medicines, your doctor may decide to change your daily dose of DACTINNA to ensure that the treatment is safe and effective for you.

Since DACTINNA may be used with other medicines against hepatitis C infection, please read the package leaflets for these medicines. If you have any questions, ask your doctor or pharmacist.

How long to take DACTINNA 用药时间

Make sure you take DACTINNA for as long as your doctor has told you to take it.

请按照医生推荐的用药时间严格用药

The duration of your treatment with DACTINNA will be either 12 or 24 weeks. The duration of your treatment will depend on whether you have previously received treatment for your hepatitis C infection, the condition of your liver, and what other medicines you will take with DACTINNA. You may have to take your other medicines for different lengths of time.

Table 1: Recommended regimens and treatment duration for Daclatasvir combination therapy
HCV genotype and patient population*基因型和病情 Treatment治疗方案 Duration治疗周期
Genotype 1 or 4 without cirrhosis
没有肝硬化的1型和4型

Daclatasvir+ sofosbuvir 12 weeks 12周
Consider prolongation of treatment to 24 weeks for patients with prior treatment including a NS3/4A protease inhibitor (see sections 4.4 and 5.1)对于有治疗经历和服用过NS3/4a蛋白酶抑制剂药物的，建议延长至24周

Genotype 1 or 4 with compensated cirrhosis
有代偿期肝硬化的1型和4型

Daclatassvir+ Sofosbuvir 24 weeks 24周
Shortening treatment to 12 weeks may be considered for previously untreated patients with cirrhosis and positive prognostic factors such as IL28B CC genotype and/or low baseline viral load.对于初治患者和有IL28B基因CC型的患者，可缩短至12周

Consider adding ribavirin for patients with very advanced liver disease or with other negative prognostic factors such as prior treatment experience.对于有严重的硬化和经治复发的病人，可考虑配合利巴韦林一起使用

Genotype 2 with or without cirrhosis基因2型没有肝硬化 Daclatasvir+ sofosbuvir 12 weeks 12周
Consider prolongation of treatment to 24 weeks for patients with prior treatment including a NS3/4A protease inhibitor (see sections 4.4 and 5.1) 对于有治疗经历和服用过NS3/4a蛋白酶抑制剂药物的，建议延长至24周

Genotype 3 with compensated cirrhosis and/or treatment experienced基因3型，不管有没有硬化或者有没有治疗经历的 Daclatasvir + Sofosbuvir 24 weeks 24周，有肝硬化的，可考虑结合利巴韦林一起使用
If you take more DACTINNA than you should 如果你多服了DACTINNA怎么办

If you accidentally take more DACTINNA tablets than your doctor recommended, contact your doctor at once or contact the nearest hospital for advice. Keep the tablet blister with you so that you can easily describe what you have taken.

如果你意外多服了本复方制剂，请立即与你的医生联系，听取他们的专业建议。

If you forget to take DACTINNA 如果你忘记了服用DACTINNA怎么办？

It is important not to miss a dose of this medicine.

If you do miss a dose:

and you notice within 18 hoursof the time you usually take DACTINNA, you must take the tablets as soon as possible. Then take the next dose at your usual time. 必须在18小时内立即服用，同时在你平时服药的时间里立即服用下一个剂量的药。
and you notice 18 hours or moreafter the time you usually take DACTINNA, wait and take the next dose at your usual time. Do not take a double dose (two doses close together). 如果你忘记服药超过18个小时，那么就等待到你平时服药的时间服用下一个剂量的药就好，不要在几个小时内同时服用两个剂量的药。
If you stop taking DACTINNA 不要中断服用DACTINNA

It is important that you continue to take DACTINNA during the whole treatment period. Otherwise the medicine may not work against the hepatitis C virus. Do not stop taking DACTINNA unless your doctor told you to stop.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

服用本复方制剂必须连续，不能中断，如果中断，病毒复发后，有可能导致本复方制剂失效。

四、Possible side effects

可能有的副作用

Like all medicines, this medicine can cause side effects, although not everybody gets them.

When DACTINNA is used together with or without ribavirin, the following side effects have been reported.

Very common (may affect more than 1 in 10 people):

headache, nausea (feeling sick), fatigue
Common (may affect up to 1 in 10 people):

decreased appetite
difficulty sleeping
dizziness
migraine
shortness of breath
hot flush
itching, dry skin, unusual hair loss or thinning, rash
diarrhoea, upper abdominal pain, constipation, excessive gas in the stomach or bowel, heartburn, vomiting
cough, nasal congestion (blocked nose), dry mouth
joint pain, aching or tender muscles, not caused by exercise
depression, anxiety, irritability
reduction in red blood cells (anaemia)
Blood tests may also show:

low red blood cell count (anaemia); the signs may include feeling tired, headaches, shortness of breath when exercising
low white blood cell count (neutropenia); the signs may include getting more infections than usual, including fevers and chills, or sore throat or mouth ulcers
low blood platelet count
changes in your liver (as shown by increased amounts of a substance called bilirubin in the blood)
很常见＞10％。头疼，恶心反胃，疲劳。常见<10％食欲减退，睡眠障碍偏头疼气短潮热

皮肤痒，干燥，非正常掉发，头发变细，皮疹，腹泻，上腹疼痛，便秘，胃肠涨气，胃灼热，呕吐，鼻塞，口干，关节疼，肌肉酸疼，沮丧，焦虑，易怒。

血常规检测，贫血，症状：疲倦，头疼，气短。中性粒细胞减少，症状：容易感染，包括发烧，发冷，或口喉溃疡。

血小板减少。肝脏的影响，症状：胆红素升高。

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via email: 125882267@qq.com, By reporting side effects you can help provide more information on the safety of this medicine.

如果你有其他的副作用，向印度塔塔药房 客服邮箱：125882267@qq.com反馈。以便我们能够向你提供更多安全的指导。

五、How to store DACTINNA

怎样保存DACTINNA

Keep this medicine out of the sight and reach of children.

请把本制剂存放到儿童视线和可接触的范围之外

Do not use this medicine after the expiry date which is stated on the carton and blister after “EXP”. The expiry date refers to the last day of that month.

请不要服用过期药品。

This medicine does not require any special storage conditions.

本制剂对于存贮条件没有特殊的要求

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

请不要随便丢弃本药品，以免破坏环境