II. Precautions
III. Indications
- See Hepatitis C Antiviral Regimen
- Hepatitis C Genotype 1a (alternative agent)
- Hepatitis C Genotype 1b
- Hepatitis C Genotype 4
- Advantages
- Priced lower than other Genotype I regimens
- May be used despite GFR <30 ml/min
IV. Contraindications
- See Hepatitis C Antiviral Regimen
- Child Pugh Class B or C (or CTP score >=7)
V. Mechanism
- Elbasvir is a NS5A Protein Inhibitor (...asvirs)
- Grazoprevir is a NS3/4A Protease Inhibitor (...previrs)
VI. Dosing
- Take once daily for 12 weeks
VII. Evaluation
- See Hepatitis C Antiviral Regimen for Pre and post-treatment protocols
VIII. Efficacy
- As effective as other agents used in Genotype 1 Hepatitis C infections
IX. Adverse Effects
- See Hepatitis C Antiviral Regimen
- Common (>5%)
- Serious
- Liver injury or hepatic failure
- Do not use in Child Pugh Class B or C
- Liver injury or hepatic failure
X. Drug Interactions
- See Hepatitis C Antiviral Regimen
-
Statins
- Atorvastatin (avoid dose >20 mg daily)
- Rosuvastatin (avoid dose >10 mg daily)
- Use lowest adequate dose of Fluvastatin, Lovastatin or Simvastatin
- Monitor for Statin-Induced Myopathy
- Avoid with strong and moderate CYP3A Inducers
- Avoid with strong CYP3A Inhibitors
- Avoid with OATP1B1/3 Inhibitors
XI. Monitoring
- See Hepatitis C Antiviral Regimen
- Recheck Liver Function Tests at 8 weeks
- If using a 16 week course, also recheck at 12 weeks
XII. Resources
XIII. References
- (2023) Presc Lett, Hepatitis C Treatment Overview, Resource #390902