dasabuvir, ombitasvir, paritaprevir, and ritonavir (Oral route)
da-SA-bue-vir, om-BIT-as-vir, par-i-TA-pre-vir, rit-OH-na-vir
Test all patients for evidence of current or prior hepatitis B virus (HBV) infection before initiating treatment with dasabuvir/ombitasvir/paritaprevir/ritonavir. HBV reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct acting antivirals and were not receiving HBV antiviral therapy. Some cases have resulted in fulminant hepatitis, hepatic failure, and death. Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV treatment and post-treatment follow-up. Initiate appropriate patient management for HBV infection as clinically indicated .
Commonly used brand name(s)
In the U.S.
- Viekira XR
Available Dosage Forms:
- Tablet, Extended Release
Therapeutic Class: Antiviral
Pharmacologic Class: Hepatitis C Virus NS5A Inhibitor
Uses For dasabuvir, ombitasvir, paritaprevir, and ritonavir
Dasabuvir, ombitasvir, paritaprevir, and ritonavir combination is used with or without ribavirin to treat chronic hepatitis C infection, including patients with compensated cirrhosis.
dasabuvir, ombitasvir, paritaprevir, and ritonavir is available only with your doctor's prescription.
Before Using dasabuvir, ombitasvir, paritaprevir, and ritonavir
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dasabuvir, ombitasvir, paritaprevir, and ritonavir, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to dasabuvir, ombitasvir, paritaprevir, and ritonavir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of Viekira XR™ in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Viekira XR™ in the elderly.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dasabuvir, ombitasvir, paritaprevir, and ritonavir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using dasabuvir, ombitasvir, paritaprevir, and ritonavir with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ergoloid Mesylates
- Ethinyl Estradiol
- Isavuconazonium Sulfate
- St John's Wort
Using dasabuvir, ombitasvir, paritaprevir, and ritonavir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ado-Trastuzumab Emtansine
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Conjugated Estrogens
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Folic Acid
- Fusidic Acid
- Inotuzumab Ozogamicin
- Irinotecan Liposome
- Morphine Sulfate Liposome
- Vincristine Sulfate Liposome
Using dasabuvir, ombitasvir, paritaprevir, and ritonavir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Estradiol Cypionate
- Estradiol Valerate
- Ethynodiol Diacetate
- Medroxyprogesterone Acetate
- Tenofovir Disoproxil Fumarate
- Valproic Acid
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using dasabuvir, ombitasvir, paritaprevir, and ritonavir with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use dasabuvir, ombitasvir, paritaprevir, and ritonavir, or give you special instructions about the use of food, alcohol, or tobacco.
- Grapefruit Juice
Other Medical Problems
The presence of other medical problems may affect the use of dasabuvir, ombitasvir, paritaprevir, and ritonavir. Make sure you tell your doctor if you have any other medical problems, especially:
- Hepatitis B, history of—Use with caution. May cause this condition to become active again.
- HIV infection—Use with caution. May make this condition worse.
- Liver disease, moderate to severe—Should not be used in patients with this condition.
Proper Use of dasabuvir, ombitasvir, paritaprevir, and ritonavir
To help clear up your infection completely, Viekira XR™ may or may not be taken together with ribavirin, for the full time of treatment, even if you begin to feel better after a few days. Also, it is important to keep the amount of medicine in your body at a steady level. To help keep the amount constant, Viekira XR™ must be used on a regular schedule.
dasabuvir, ombitasvir, paritaprevir, and ritonavir should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.
Swallow the extended-release tablet whole. Do not crush, break, or chew it. Take dasabuvir, ombitasvir, paritaprevir, and ritonavir with food.
Do not drink alcohol within 4 hours of taking Viekira XR™.
The dose of dasabuvir, ombitasvir, paritaprevir, and ritonavir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dasabuvir, ombitasvir, paritaprevir, and ritonavir. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (extended-release tablets):
- For chronic hepatitis C virus infection, with or without ribavirin:
- Adults—3 tablets taken once a day. Each tablet contains 200 mg of dasabuvir, 8.33 mg of ombitasvir, 50 mg of paritaprevir, and 33.33 mg of ritonavir.
- Children—Use and dose must be determined by your doctor.
- For chronic hepatitis C virus infection, with or without ribavirin:
If you miss a dose of dasabuvir, ombitasvir, paritaprevir, and ritonavir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using dasabuvir, ombitasvir, paritaprevir, and ritonavir
It is very important that your doctor check your progress at regular visits to make sure dasabuvir, ombitasvir, paritaprevir, and ritonavir is working properly. Blood tests may be needed to check for unwanted effects.
Using dasabuvir, ombitasvir, paritaprevir, and ritonavir together with ribavirin while you are pregnant can harm your unborn baby. These medicines may also cause birth defects if the father is using it when his sexual partner is pregnant. Avoid pregnancy during combination treatment with dasabuvir, ombitasvir, paritaprevir, and ritonavir and ribavirin for 6 months of stopping treatment. If a pregnancy occurs while you are using these medicines, tell your doctor right away.
Do not use the following medicines while you are using dasabuvir, ombitasvir, paritaprevir, and ritonavir: alfuzosin (Uroxatral®), cisapride (Propulsid®), colchicine (Colcrys®), dronedarone (Multaq®), efavirenz (Sustiva®), ethinyl estradiol (Norinyl®, Ortho Evra®), everolimus (Afinitor®), gemfibrozil (Lopid®), lurasidone (Latuda®), oral midazolam (Versed®), pimozide (Orap®), ranolazine (Ranexa®), rifampin (Rifadin®, Rimactane®), sildenafil (Revatio®), sirolimus (Rapamune®), St. John's wort, tacrolimus (Prograf®), triazolam (Halcion®), certain medicines to lower cholesterol (such as atorvastatin, lovastatin, simvastatin, Mevacor®, Zocor®), medicine to treat seizures (such as carbamazepine, phenobarbital, phenytoin, Tegretol®), or ergot medicines (such as dihydroergotamine, ergotamine, methylergonovine, Cafergot®, Ergomar®, Wigraine®). Using Viekira XR™ with any of these medicines can cause very serious medical problems.
Check with your doctor right away if you are weak or tired, have onset of confusion, have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
dasabuvir, ombitasvir, paritaprevir, and ritonavir Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:Incidence not known
- Blistering, peeling, or loosening of the skin
- dark-colored urine
- general feeling of tiredness or weakness
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- red skin lesions, often with a purple center
- red, irritated eyes
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- stomach pain, continuing
- unusual tiredness or weakness
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Blistering, crusting, irritation, itching, or reddening of the skin
- cracked, dry, scaly skin
- hives or welts, or skin rash
- increased sensitivity of the skin to sunlight
- lack or loss of strength
- redness or other discoloration of the skin
- severe sunburn
- trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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