Elbasvir Grazoprevir Brand Name– ZEPATIER
What is Elbasvir Grazoprevir
Elbasvir grazoprevir is a combination oral product approved for the treatment of chronic hepatitis C virus (HCV) genotypes 1 and 4 infections in adult patients, including patients with cirrhosis and HCV/HIV coinfection.
The product is available as a once daily oral tablet, which contains an HCV NS5A inhibitor (elbasvir) and an HCV NS3/4A protease inhibitor (grazoprevir). Although this drug may constitute a complete HCV treatment regimen, certain patients will require concurrent treatment with ribavirin.
Prior to initiating therapy, patients infected with HCV genotype 1a must undergo testing for NS5A resistance-associated polymorphisms. In addition, liver function tests are required for all patients prior to and during treatment; administration of the drug is contraindicated in patients with moderate to severe hepatic impairment (Child-Pugh B and C) and in those with any history of prior hepatic decompensation.
Evaluate patients profile for potential drug interactions; elbasvir; grazoprevir is contraindicated for use with efavirenz, inhibitors of the organic anion transporting polypeptides (OATP1B1/3), and strong inducers of CYP3A hepatic enzymes.
Indications
- hepatitis C infection
- hepatitis C virus
NOTE: Avoid use of NS3 protease inhibitors, which includes grazoprevir, in patients with current or prior history of decompensated hepatic disease or with a current Child-Pugh score of 7 or more.
NOTE: Baseline NS5A resistance-associated substitutions (RAS) testing recommended for patients infected with HCV genotype 1a; if present, consider alternative therapy or add ribavirin and increase treatment duration. RAS testing NOT recommended for patient infected with HCV genotypes 1b or 4
Side Effects
- abdominal pain
- anemia
- angioedema
- arthralgia
- depression
- diarrhea
- dyspnea
- elevated hepatic enzymes
- fatigue
- headache
- hepatic decompensation
- hepatic failure
- hepatitis B exacerbation
- hyperbilirubinemia
- insomnia
- irritability
- nausea
- pruritus
- rash
Monitoring Parameters
- hepatitis B serology
- LFTs
- plasma hepatitis C RNA
- plasma HIV RNA
- pregnancy testing
Contraindications
- alcoholism
- anticoagulant therapy
- ascites
- Asian patients
- breast-feeding
- diabetes mellitus
- females
- geriatric
- hepatic decompensation
- hepatic disease
- hepatic encephalopathy
- hepatitis B exacerbation
- hepatitis C and HIV coinfection
- hepatocellular cancer
- hyperglycemia
- hypoglycemia
- jaundice
- liver transplant
- male-mediated teratogenicity
- pregnancy
- pregnancy testing
- use with ribavirin
Interactions
- Abiraterone
- Acarbose
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Acetohexamide
- Albiglutide
- Aldesleukin, IL-2
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Almotriptan
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpelisib
- Alprazolam
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Antidiabetic Agents
- Apalutamide
- Aripiprazole
- Armodafinil
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avanafil
- Azelastine; Fluticasone
- Barbiturates
- Basiliximab
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Bexarotene
- Boceprevir
- Bosentan
- Bosutinib
- Brentuximab vedotin
- Brexpiprazole
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Buspirone
- Butabarbital
- Canagliflozin
- Canagliflozin; Metformin
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Cenobamate
- Ceritinib
- Cevimeline
- Chloramphenicol
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpropamide
- Cilostazol
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clobazam
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Cobimetinib
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Conjugated Estrogens; Medroxyprogesterone
- Cyclosporine
- Dabrafenib
- Daclatasvir
- Danazol
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Dapsone
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Daunorubicin
- Deferasirox
- Delavirdine
- Dexamethasone
- Dextromethorphan; Quinidine
- Diazepam
- Diclofenac
- Diclofenac; Misoprostol
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Disulfiram
- Docetaxel
- Dolasetron
- Donepezil
- Donepezil; Memantine
- Doxorubicin
- Dronabinol
- Dronedarone
- Droperidol
- Dulaglutide
- Dutasteride; Tamsulosin
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enalapril; Felodipine
- Enzalutamide
- Ergot alkaloids
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Eslicarbazepine
- Estazolam
- Estradiol Cypionate; Medroxyprogesterone
- Eszopiclone
- Ethosuximide
- Etravirine
- Exenatide
- Ezetimibe; Simvastatin
- Felbamate
- Felodipine
- Fentanyl
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Flurazepam
- Flutamide
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvastatin
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Fostemsavir
- Gemfibrozil
- Glecaprevir; Pibrentasvir
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Granisetron
- grapefruit juice
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxyprogesterone
- Ibrutinib
- Ibuprofen; Oxycodone
- Idelalisib
- Imatinib
- Imipramine
- Indinavir
- Insulin Aspart
- Insulin Aspart; Insulin Aspart Protamine
- Insulin Degludec; Liraglutide
- Insulin Detemir
- Insulin Glargine
- Insulin Glargine; Lixisenatide
- Insulin Glulisine
- Insulin Lispro
- Insulin Lispro; Insulin Lispro Protamine
- Insulin, Inhaled
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isophane Insulin (NPH)
- Isradipine
- Itraconazole
- Ivabradine
- Ixabepilone
- Ketoconazole
- Ledipasvir; Sofosbuvir
- Lemborexant
- Lente Insulin
- Letermovir
- Levomilnacipran
- Lidocaine
- Lidocaine; Prilocaine
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lixisenatide
- Lomitapide
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorlatinib
- Losartan
- Lovastatin
- Lovastatin; Niacin
- Lurasidone
- Macitentan
- Maprotiline
- Maraviroc
- Medroxyprogesterone
- Mefloquine
- Meloxicam
- Mephobarbital
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methohexital
- Methotrexate
- Midazolam
- Mifepristone
- Miglitol
- Mirtazapine
- Mitotane
- Mitoxantrone
- Modafinil
- Nafcillin
- Nateglinide
- Nefazodone
- Nelfinavir
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin; Simvastatin
- Nicardipine
- Nifedipine
- Nilotinib
- Nimodipine
- Nisoldipine
- Nortriptyline
- Obeticholic Acid
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
- Oritavancin
- Oxybutynin
- Oxycodone
- Ozanimod
- Paclitaxel
- Palonosetron
- Panobinostat
- Paricalcitol
- Pazopanib
- Pentobarbital
- Perampanel
- Perindopril; Amlodipine
- Perphenazine; Amitriptyline
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Pimozide
- Pioglitazone
- Pirfenidone
- Posaconazole
- Pramlintide
- Primidone
- Propafenone
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Regular Insulin
- Regular Insulin; Isophane Insulin (NPH)
- Repaglinide
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rimegepant
- Riociguat
- Risperidone
- Ritonavir
- Rivaroxaban
- Roflumilast
- Rolapitant
- Romidepsin
- Ropivacaine
- Rosiglitazone
- Rosuvastatin
- Ruxolitinib
- Saquinavir
- Saxagliptin
- Secobarbital
- Selegiline
- Selexipag
- Semaglutide
- Sertraline
- Sibutramine
- Sildenafil
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Sirolimus
- Sitagliptin
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- Sonidegib
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sulfasalazine
- Suvorexant
- Tacrolimus
- Tadalafil
- Talazoparib
- Tamsulosin
- Tasimelteon
- Telithromycin
- Telotristat Ethyl
- Teniposide
- Terbinafine
- Teriflunomide
- Testosterone
- Theophylline, Aminophylline
- Thiopental
- Tiagabine
- Ticagrelor
- Tinidazole
- Tipranavir
- Tolazamide
- Tolbutamide
- Tolterodine
- Tolvaptan
- Topiramate
- Topotecan
- Tramadol
- Trandolapril; Verapamil
- Trazodone
- Triazolam
- Tucatinib
- Ubrogepant
- Ultralente Insulin
- Umeclidinium; Vilanterol
- Valproic Acid, Divalproex Sodium
- Vemurafenib
- Venlafaxine
- Verapamil
- Vilazodone
- Vincristine
- Vincristine Liposomal
- Vinorelbine
- Vorapaxar
- Voriconazole
- Warfarin
- Yohimbine
- Zafirlukast
- Zileuton
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zonisamide
