Glecaprevir Pibrentasvir

Aka: Glecaprevir Pibrentasvir, Glecaprevir/Pibrentasvir, Mavyret

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II. Precautions

  1. See Hepatitis C Antiviral Regimen

III. Indications

  1. See Hepatitis C Antiviral Regimen
  2. General
    1. Initial therapy for any Genotype in patients without Cirrhosis (or with Class A compensated Cirrhosis)
    2. Salvage therapy for failed initial protocol for up to 16 weeks
  3. Genotypes
    1. Hepatitis CGenotype 1a
    2. Hepatitis CGenotype 1b
    3. Hepatitis CGenotype 2
    4. Hepatitis CGenotype 3
    5. Hepatitis CGenotype 4
    6. Hepatitis CGenotype 5 or 6

IV. Contraindications

  1. See Hepatitis C Antiviral Regimen
  2. Advanced Cirrhosis with Child Pugh Class B or C (or CTP score >=7)
  3. No restriction based on Renal Function

V. Mechanism

  1. Glecaprevir is a NS3/4A Protease Inhibitor (...previrs)
  2. Pibrentasvir (Mavyret) is a NS5A Protein Inhibitor (...asvirs)

VI. Dosing

  1. Take three tablets once daily for 8 weeks

VII. Evaluation

  1. See Hepatitis C Antiviral Regimen for Pre and post-treatment protocols

VIII. Adverse Effects

  1. See Hepatitis C Antiviral Regimen
  2. Common (>10%)
    1. Headache
    2. Fatigue
  3. Serious
    1. Liver injury or hepatic failure
      1. Do not use in Child Pugh Class B or C

IX. Drug Interactions

  1. See Hepatitis C Antiviral Regimen
  2. Safe drugs
    1. No significant interactions with Opioid Addiction therapy (Methadone, Buprenorphine)
    2. Proton Pump Inhibitors are safe to use with Mavyret
    3. Amiodarone is safe to use with Mavyret
  3. Contraindicated drugs (or limited dosing)
    1. Atazanavir
    2. Carbamazepine
    3. Cyclosporine (at doses >100 mg/day)
    4. Dabigatran
    5. Darunavir
    6. Digoxin (reduce dose to 50%)
    7. Efavirenz
    8. Ethinyl Estradiol
      1. Avoid use with Ethinyl Estradiol containing contraceptives
    9. Herbals
      1. St Johns Wort
    10. Lopinavir
    11. Phenobarbital
    12. Phenytoin
    13. Rifampin
    14. Ritonavir
    15. Statins
      1. Atorvastatin
      2. Lovastatin
      3. Simvastatin
      4. Limit Rosuvastatin to 5 to 10 mg/day
      5. Lower Pravastatin dose 50%
      6. Limit Fluvastatin and Pitavastatin to lowest effective dose

X. Monitoring

  1. See Hepatitis C Antiviral Regimen

XI. Efficacy

  1. Hepatitis C clearance rate of >95% against all Genotypes

XII. Resources

  1. Mavyret (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7bf99777-0401-9095-8645-16c6e907fcc0

XIII. References

  1. (2023) Presc Lett, Hepatitis C Treatment Overview, Resource #390902

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Related Studies

Cost: Medications

mavyret (on 10/12/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
MAVYRET 100-40 MG TABLET $152.79 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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