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Elbasvir and grazoprevir

Generic Name: elbasvir and grazoprevir (ELB as vir and graz OH pre vir)
Brand Name: Zepatier

Medically reviewed on Jul 10, 2018

What is elbasvir and grazoprevir?

See also: Mavyret

Elbasvir and grazoprevir are antiviral medicines that prevent hepatitis C (HCV) from multiplying in your body.

Elbasvir and grazoprevir is a combination medicine used to treat chronic hepatitis C in adults. elbasvir and grazoprevir is sometimes given together with another drug called ribavirin.

Elbasvir and grazoprevir treats specific genotypes of hepatitis C, and only in certain people. Use only the medications prescribed for you. Do not share your medicine with other people.

Elbasvir and grazoprevir is sometimes used in people who also have HIV. This medicine is not a treatment for HIV or AIDS.

Elbasvir and grazoprevir may also be used for purposes not listed in this medication guide.

Important Information

You should not use this medicine if you have moderate or severe liver disease.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

If you've ever had hepatitis B, using elbasvir and grazoprevir can cause this virus to become active or get worse. Tell your doctor if you don't feel well and you have right-sided upper stomach pain, vomiting, loss of appetite, or yellowing of your skin or eyes.

Before taking this medicine

You should not use elbasvir and grazoprevir if you are allergic to elbasvir or grazoprevir, or if you have:

  • moderate or severe liver disease.

If you take elbasvir and grazoprevir with ribavirin: There may be other reasons you should not take this combination treatment. Tell your doctor about all your medical conditions.

Some medicines can cause unwanted or dangerous effects when used with elbasvir and grazoprevir. Your doctor may change your treatment plan if you also use:

Tell your doctor if you have ever had:

  • hepatitis B;

  • liver problems other than hepatitis C;

  • HIV (human immunodeficiency virus);

  • a liver transplant, or if you are waiting to have a liver transplant; or

  • if you use a blood thinner (warfarin, Coumadin, Jantoven) and you have routine "INR" or prothrombin time tests.

It is not known whether elbasvir and grazoprevir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Elbasvir and grazoprevir is sometimes used in combination with ribavirin. Ribavirin can cause birth defects or death in an unborn baby if the mother or father is using this medicine.

  • If you are a woman, do not use ribavirin if you are pregnant. You may need to have a negative pregnancy test before taking ribavirin and every month during your treatment.

  • If you are a man, do not use ribavirin if your sexual partner is pregnant. An unborn baby could be harmed if you have sex with a pregnant woman while you are taking ribavirin.

  • Both men and women should use at least 2 effective forms of birth control to prevent pregnancy. Keep using 2 forms of birth control for at least 6 months after your last dose of ribavirin.

  • Tell your doctor right away if a pregnancy occurs while either the mother or the father is using ribavirin.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Elbasvir and grazoprevir is not approved for use by anyone younger than 18 years old.

How should I take elbasvir and grazoprevir?

Your doctor will perform blood tests to make sure you do not have conditions that would prevent you from safely using elbasvir and grazoprevir.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

You may take elbasvir and grazoprevir with or without food.

Take the medicine at the same time each day.

You will need frequent blood tests to check your liver function.

If you've ever had hepatitis B, using elbasvir and grazoprevir can cause this virus to become active or get worse. You may need frequent liver function tests while using this medicine and for several months after you stop.

You should not stop using elbasvir and grazoprevir suddenly. Stopping suddenly could make your hepatitis C harder to treat with antiviral medicine.

Use all hepatitis C medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice. Every person with chronic hepatitis C should remain under the care of a doctor.

Store at room temperature away from moisture and heat. Keep each tablet in the foil blister pack until you are ready to take it.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking elbasvir and grazoprevir?

Using elbasvir and grazoprevir will not prevent your disease from spreading. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HCV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Elbasvir and grazoprevir side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have new or worsening symptoms such as:

  • not tiredness, not feeling well;

  • right-sided upper stomach pain, vomiting, loss of appetite;

  • dark urine, clay-colored stools;

  • jaundice (yellowing of the skin or eyes); or

  • (if you also take ribavirin) low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Elbasvir and grazoprevir dosing information

Usual Adult Dose for Chronic Hepatitis C:

1 tablet orally once a day

Recommended Regimen and Duration of Therapy:
-Genotype 1a, therapy-naive or peginterferon alfa/ribavirin-experienced without baseline nonstructural protein 5A (NS5A) polymorphisms: Elbasvir-grazoprevir for 12 weeks
-Genotype 1a, therapy-naive or peginterferon alfa/ribavirin-experienced with baseline NS5A polymorphisms: Elbasvir-grazoprevir plus ribavirin for 16 weeks
-Genotype 1b, therapy-naive or peginterferon alfa/ribavirin-experienced: Elbasvir-grazoprevir for 12 weeks
-Genotype 1a or 1b, peginterferon alfa/ribavirin/HCV protease inhibitor-experienced: Elbasvir-grazoprevir plus ribavirin for 12 weeks
-Genotype 4, therapy-naive: Elbasvir-grazoprevir for 12 weeks
-Genotype 4, peginterferon alfa/ribavirin-experienced: Elbasvir-grazoprevir plus ribavirin for 16 weeks

Comments:
-This drug should be used with ribavirin in certain patient populations.
-Hepatic laboratory testing recommended prior to and during therapy.
-Peginterferon alfa/ribavirin-experienced: Patients who have failed therapy with peginterferon alfa plus ribavirin
-Baseline NS5A polymorphisms: NS5A resistance-associated polymorphisms at amino acid positions 28, 30, 31, or 93.
-Peginterferon alfa/ribavirin/HCV protease inhibitor-experienced: Patients who have failed therapy with peginterferon alfa plus ribavirin plus HCV NS3/4A protease inhibitor (e.g., boceprevir, simeprevir, telaprevir)
-Optimal regimen and duration of therapy not established for peginterferon alfa/ribavirin/HCV protease inhibitor-experienced genotype 1a-infected patients with at least 1 baseline NS5A resistance-associated polymorphism at positions 28, 30, 31, and 93.
-The manufacturer product information for ribavirin should be consulted regarding dosing and dose adjustments (if applicable).

Use: For the treatment of chronic HCV genotype 1 or 4 infection

What other drugs will affect elbasvir and grazoprevir?

When you start or stop taking elbasvir and grazoprevir, your doctor may need to adjust the doses of any other medicines you take on a regular basis.

Many drugs can affect elbasvir and grazoprevir, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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