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ZEPATIER® (elbasvir/grazoprevir)

DDIs and dosing simplicity

Updated on 18/06/2019

HEPATITIS C
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ZEPATIER can be used with the following drugs without clinically significant interactions or dose adjustments2,3

Other categories without clinically significant interactions or dose adjustments include: antiarrhythmics (digoxin), antidepressants*, beta blockers, gastric acid suppressants (H2-receptor antagonist (famotidine), Proton Pump Inhibitor (pantoprazole), antacids), HBV and HIV NRTIs, HIV NNRTIs (rilpivirine), HIV integrase inhibitors (raltegravir and dolutegravir), HCV antivirals (sofosbuvir and ribavirin), immunosuppressants (prednisone, mycophenolate mofetil, tacrolimus**), phosphate binders (calcium acetate, sevelamer carbonate) and statins (pitavastatin, pravastatin).

Please consult the ZEPATIER SmPC before prescribing.2

*Coadministration has not been studied with mianserin, which is metabolised by CYPs 2D6 and 1A2, and to a lesser extent by CYP3A4. Grazoprevir is a weak CYP3A4 inhibitor. The clinical significance of any potential interaction is unknown3

**Frequent monitoring of tacrolimus whole blood concentrations, changes in renal function, and tacrolimus-associated adverse events is recommended upon the initiation of coadministration with ZEPATIER2

Other statins (HMG-CoA reductase inhibitors) - use low dose when concomitantly given with ZEPATIER2

Glucose levels of diabetic patients initiating DAA therapy should be closely monitored, particularly within the first 3 months, and their diabetic medication modified when necessary

Dosing simplicity2

Cure defined as Cure of HCV infection = Sustained Virologic Response (SVR), the primary endpoint in all studies, was defined as Hepatitis C Virus (HCV) Ribonucleic Acid (RNA) less than the Lower Limit of Quantification (LLOQ) (≤15 IU/ml) at 12 weeks after the cessation of treatment.4

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References

  1. Höner zu Siederdissen C, Maasoumy B, Marra F, et al. Drug-drug interactions with novel all oral interferon-free antiviral agents in a large real-world cohort. Clin Infect Dis. 2016;62:561–567.
  2. ZEPATIER Summary of Product Characteristics.
  3. Liverpool Drug Interactions Group, University of Liverpool. HCV directly acting antivirals & RBV. https://liverpool-hiv-hep.s3.amazonaws.com/prescribing_resources/pdfs/000/000/016/original/HCVChart_2019_2%28Apr%29.pdf?1556015400. Charts revised April 2019.
  4. European Association for the Study of Liver. J Hepatol 2018;69;461-511.

Supporting documentation

Prescribing Information | Summary of Product Characteristics | Patient Information Leaflet

GB-ZEP-00104 | Date of Preparation: June 2019