Daclatasvir isn’t just another drug name you hear in a doctor’s office. For someone diagnosed with hepatitis C, it can mean the difference between years of liver damage and a clean bill of health. Since its approval in 2015, daclatasvir has helped millions of people clear the hepatitis C virus from their bodies-often in just 12 weeks. But how does it actually work? And why is it paired with other drugs instead of used alone?
What Is Daclatasvir?
Daclatasvir is a direct-acting antiviral (DAA) medication that targets the hepatitis C virus (HCV) by blocking the NS5A protein, which the virus needs to replicate. Also known as DCV, it was developed by Bristol-Myers Squibb and approved by the FDA in July 2015.
Before daclatasvir, hepatitis C treatment meant interferon injections and ribavirin pills-side effects included severe fatigue, depression, and anemia. Treatment could last up to 48 weeks, and success rates hovered around 50%. Daclatasvir changed that. It’s part of a new generation of drugs that are taken orally, have fewer side effects, and cure over 90% of cases.
How Daclatasvir Works Against Hepatitis C
The hepatitis C virus doesn’t just sit in your liver. It’s constantly copying itself, using proteins like NS5A to assemble new virus particles. Daclatasvir locks onto the NS5A protein and stops it from doing its job. Without NS5A, the virus can’t make new copies. It doesn’t kill the virus outright-it just stops it from spreading.
This is why daclatasvir is never used alone. If you take it by itself, the virus can quickly mutate and become resistant. That’s why it’s always combined with another antiviral, usually sofosbuvir. Together, they attack two different parts of the virus at once. This dual attack makes resistance extremely rare.
Studies show that when daclatasvir is paired with sofosbuvir, cure rates exceed 95% for genotype 1 and 3-the most common strains in the U.S. and Europe. For genotype 2, it’s often used with ribavirin instead. The exact combo depends on your virus type, liver condition, and whether you’ve been treated before.
Who Benefits Most from Daclatasvir?
Daclatasvir isn’t for everyone, but it’s a top choice for many. It’s approved for adults with chronic hepatitis C infection, especially those with:
- Genotype 1 or 3 HCV
- Advanced liver scarring (cirrhosis)
- Previous treatment failure with older therapies
- No history of liver transplant
It’s also safe for people with HIV co-infection. In fact, the combination of daclatasvir and sofosbuvir is one of the few regimens recommended for both hepatitis C and HIV patients because it doesn’t interfere with most HIV medications.
It’s not typically used in people with severe kidney disease or those under 18, unless under special supervision. Pregnant women should avoid it because the safety of daclatasvir during pregnancy hasn’t been fully studied.
How It’s Taken and What to Expect
Daclatasvir comes as a 60 mg tablet, taken once daily with or without food. Most treatment courses last 12 weeks, though some patients with cirrhosis or prior treatment failure may need 24 weeks. You’ll usually take it alongside sofosbuvir (400 mg daily), forming a single-pill combination in some branded versions.
Side effects are mild for most people. The most common ones include:
- Headache
- Fatigue
- Nausea
- Insomnia
Unlike older treatments, you won’t lose your hair, get flu-like symptoms every week, or need regular blood draws just to monitor side effects. Blood tests are still done-to check if the virus is gone-but they’re not for toxicity.
One rare but serious risk is reactivation of hepatitis B in people who’ve had it before. If you’ve ever tested positive for hepatitis B, your doctor will check your liver enzymes and viral load before starting daclatasvir and monitor you closely during treatment.
Daclatasvir vs. Other Hepatitis C Drugs
There are now over a dozen DAA combinations available. So why choose daclatasvir?
| Drug Combination | Genotypes Covered | Duration | Cure Rate | Key Advantage |
|---|---|---|---|---|
| Daclatasvir + Sofosbuvir | 1, 2, 3, 4 | 12-24 weeks | 94-99% | Highly effective for genotype 3 |
| Glecaprevir/Pibrentasvir (Mavyret) | 1-6 | 8-16 weeks | 95-99% | Shortest treatment for most |
| Elbasvir/Grazoprevir (Zepatier) | 1, 4 | 8-16 weeks | 94-97% | Good for genotype 4 |
| Sofosbuvir/Velpatasvir (Epclusa) | 1-6 | 12 weeks | 98% | One-pill, once-daily for all genotypes |
Daclatasvir’s biggest strength is its performance against genotype 3, which is harder to treat than other types. While newer all-in-one pills like Epclusa or Mavyret are simpler, daclatasvir remains a top option for genotype 3 patients with cirrhosis or those who’ve failed prior treatments.
What Happens After Treatment?
After 12 or 24 weeks, you’ll get a blood test called an HCV RNA test. If the virus is undetectable 12 weeks after finishing treatment, you’re considered cured. This is called a sustained virologic response (SVR12).
Once you’re cured, your liver can begin to heal. Scarring may improve over time, especially if you avoid alcohol and maintain a healthy weight. But you’re not immune to reinfection. If you use injection drugs or have unprotected sex with someone who has HCV, you can catch it again.
Unlike hepatitis B, there’s no vaccine for hepatitis C. So even after being cured, you still need to practice safe behaviors.
Cost and Accessibility
When daclatasvir first came out, it cost over $60,000 for a full course. Today, generic versions are widely available in the U.S. and other countries, bringing the price down to under $1,000 for a 12-week supply in many places. Insurance usually covers it, and patient assistance programs exist for those without coverage.
In low- and middle-income countries, generic daclatasvir is sold for as little as $15 per month through organizations like the Medicines Patent Pool. This has made it one of the most accessible hepatitis C treatments worldwide.
Common Misconceptions
There’s a lot of confusion around daclatasvir. Here are the biggest myths:
- Myth: You can take daclatasvir alone. Fact: It must be combined with another antiviral to prevent resistance.
- Myth: It works for everyone. Fact: It’s not recommended for people with severe kidney failure or those who’ve had a liver transplant without close monitoring.
- Myth: Once cured, you can’t get hepatitis C again. Fact: You can be reinfected if exposed again.
- Myth: You’ll feel better right away. Fact: Many people feel the same during treatment-it’s the long-term liver protection that matters.
What Comes Next After Daclatasvir?
Even with highly effective treatments like daclatasvir, hepatitis C still affects over 50 million people globally. The challenge now isn’t finding a cure-it’s finding the people who don’t know they’re infected. Only about 20% of people with HCV have been diagnosed.
Screening is key. The CDC recommends one-time testing for all adults, especially those born between 1945 and 1965. If you’ve ever used injection drugs, had a blood transfusion before 1992, or have unexplained liver enzyme elevations, get tested.
Daclatasvir isn’t the end of the story. It’s part of a larger shift: turning a deadly, lifelong disease into something you can cure in three months. That’s a medical breakthrough-and it’s happening right now, in clinics and pharmacies around the world.
Is daclatasvir still used today, or are there better options now?
Yes, daclatasvir is still used, especially for genotype 3 hepatitis C and in patients who’ve failed other treatments. While newer one-pill regimens like Epclusa or Mavyret are simpler, daclatasvir remains a top choice for certain cases, particularly when combined with sofosbuvir. Its effectiveness against genotype 3 makes it valuable in real-world practice.
Can daclatasvir cure hepatitis C in people with cirrhosis?
Yes. Clinical trials and real-world data show that daclatasvir plus sofosbuvir cures over 90% of patients with cirrhosis, even in advanced cases. Treatment may be extended to 24 weeks for those with decompensated cirrhosis, and close monitoring is needed. The cure rate is still high enough to make it a standard option.
Does daclatasvir interact with other medications?
Yes. Daclatasvir can interact with certain drugs, including some seizure medications (like carbamazepine), St. John’s wort, and certain HIV antivirals. It can also raise levels of statins, increasing the risk of muscle damage. Always tell your doctor about all medications, supplements, and herbal products you’re taking before starting treatment.
How long does it take for daclatasvir to start working?
Daclatasvir starts blocking the virus within hours of the first dose. But you won’t feel better right away. The virus levels drop steadily over weeks. Most people see a 99% reduction in viral load within the first 4 weeks. The goal isn’t immediate symptom relief-it’s long-term clearance of the virus from your body.
Can you drink alcohol while taking daclatasvir?
It’s strongly advised to avoid alcohol during and after treatment. Alcohol speeds up liver damage, even if the virus is gone. If you have cirrhosis or advanced scarring, any alcohol can increase your risk of liver failure or cancer. Stopping alcohol is one of the most important steps you can take to protect your liver after being cured.
If you’ve been told you have hepatitis C, don’t wait. The tools to cure it are here. Daclatasvir, along with other modern drugs, has turned what was once a slow, deadly disease into something that can be fixed in a few months. The next step isn’t more research-it’s getting tested and starting treatment.
Zac Gray
November 20, 2025 AT 11:23Man, I remember when hepatitis C meant six months of feeling like a zombie with a side of depression and a $10,000 bill. Now I can just pop a pill, binge Netflix, and get cured? Wild. Daclatasvir didn’t just change the game-it turned it into a casual Sunday stroll. I know someone who went from cirrhosis to clean liver in 12 weeks. No injections. No hospital visits. Just a prescription and a lot of coffee. The fact that it works for genotype 3 is a godsend-those cases used to be the nightmare scenario. Honestly, if you’re reading this and you’ve never been tested, go do it. Your future self will high-five you.