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Mavyret

Mavyret (glecaprevir and pibrentasvir) is an antiviral medication used to treat chronic hepatitis C virus (HCV) infection in adults and children aged 3 years and older. It is a combination of two drugs: glecaprevir, a protease inhibitor, and pibrentasvir, an NS5A inhibitor. These drugs work together to stop the virus from multiplying in the body, helping to clear the infection. Mavyret is approved for use across all six major genotypes of hepatitis C and is effective in individuals with or without cirrhosis. The treatment duration is generally shorter than other hepatitis C therapies, often lasting 8 to 12 weeks.

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Frequently Asked Questions

How long does it take for Mavyret to cure hepatitis C?
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Mavyret can cure hepatitis C in as little as 8 weeks for most treatment-naïve patients without cirrhosis. Some individuals with prior treatment failure or cirrhosis may require 12 weeks of therapy.

Can I drink alcohol while taking Mavyret?
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It is best to avoid alcohol while taking Mavyret, as alcohol can further damage the liver, which is already affected by hepatitis C.

What should I do if I miss a dose of Mavyret?
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If you miss a dose and remember within 18 hours, take it with food as soon as possible. If more than 18 hours have passed, skip the missed dose and continue with your next scheduled dose.

Can Mavyret be used to treat hepatitis C in children?
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Yes, Mavyret is approved for use in children aged 3 years and older with hepatitis C.

Is it possible to be re-infected with hepatitis C after completing treatment with Mavyret?
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Yes, even after a successful treatment with Mavyret that clears the virus, it is possible to be re-infected if exposed to hepatitis C again. Taking precautions to avoid HCV exposure is important.

Comprehensive Drug Guide

How Does Mavyret Work?

  • Glecaprevir: Inhibits the NS3/4A protease, an enzyme essential for the hepatitis C virus to replicate and process viral proteins.
  • Pibrentasvir: Inhibits the NS5A protein, which is also necessary for viral replication. By blocking these enzymes, Mavyret effectively prevents the virus from multiplying and spreading within the body, leading to the eradication of the infection in most cases.

Common Dosages

  • The standard dose is 3 tablets taken once daily with food.

Typical Dosing

  • The typical course of treatment is 8 weeks for most patients who are treatment-naïve (have never been treated for HCV) and do not have cirrhosis.
  • Patients with compensated cirrhosis or who have failed previous HCV treatments may require a longer treatment course of 12 weeks.
  • The tablets must be taken with food to ensure proper absorption.

Typical Dosing

FDA Approved Indications

  • Chronic hepatitis C virus (HCV) infection in adults and children aged 3 years and older, including those with HCV genotypes 1, 2, 3, 4, 5, or 6.
  • It can be used in patients with or without compensated cirrhosis (Child-Pugh A).
  • It is also indicated for patients with HCV infection who have previously been treated with an NS5A inhibitor or protease inhibitor, but not both.

Who Shouldn't Take Mavyret?

  • Severe liver impairment (Child-Pugh class B or C).
  • Known hypersensitivity to glecaprevir, pibrentasvir, or any other components in the formulation.
  • Co-administration with certain drugs, including rifampin and atazanavir, which can interact with Mavyret and decrease its effectiveness.

Advice From The Pharmacist

  • Take Mavyret exactly as prescribed, with food to enhance its absorption.
  • Do not skip doses or stop the medication early, even if you start to feel better. Completing the full course of treatment is crucial to fully clearing the hepatitis C infection.
  • Mavyret has few drug interactions, but some medications (such as rifampin or St. John’s wort) can reduce its effectiveness. Inform your healthcare provider about all medications and supplements you are taking.
  • If you vomit within 3 hours of taking a dose, take another dose with food. If it’s been more than 3 hours, continue with your next scheduled dose.

Side Effects of Mavyret

Common Side Effects

  • Headache
  • Fatigue
  • Nausea
  • Diarrhea

Uncommon/Severe Side Effects

  • Reactivation of hepatitis B in individuals who are co-infected with both hepatitis B and C. Patients should be screened for hepatitis B before starting Mavyret.
  • Severe liver problems in individuals with advanced liver disease. Monitor liver function during treatment, especially in those with a history of liver issues.

Risks and Warnings of Mavyret

  • Hepatitis B Reactivation: Mavyret may cause reactivation of hepatitis B in patients who are co-infected with HCV and hepatitis B virus (HBV). This can lead to serious liver damage, liver failure, or death. All patients should be tested for hepatitis B before starting Mavyret.
  • Liver Impairment: Mavyret should not be used in patients with severe liver impairment (Child-Pugh B or C). For those with mild liver impairment, liver function should be regularly monitored during treatment.
  • Drug Interactions: Mavyret should not be taken with certain drugs like rifampin, atazanavir, and St. John’s wort, as these can interfere with Mavyret’s effectiveness.

Interactions with Mavyret

Common Drug Interactions

  • Rifampin: Significantly decreases the effectiveness of Mavyret.
  • Atazanavir: This HIV protease inhibitor can reduce the concentration of Mavyret, making it less effective.
  • St. John’s wort: Reduces Mavyret’s effectiveness and should be avoided.
  • Statins: Some statins (used for cholesterol control) may increase the risk of muscle pain or damage when taken with Mavyret, so your healthcare provider may need to adjust your dose or monitor you more closely.

Alternatives to Mavyret

  • Harvoni (ledipasvir/sofosbuvir): Another combination antiviral treatment for HCV, effective for genotypes 1, 4, 5, and 6.
  • Epclusa (sofosbuvir/velpatasvir): A pan-genotypic HCV treatment (effective against all six major genotypes) similar to Mavyret, but typically requires 12 weeks of therapy.
  • Zepatier (elbasvir/grazoprevir): Another treatment option for patients with HCV genotypes 1 and 4.
  • Vosevi (sofosbuvir/velpatasvir/voxilaprevir): Used in patients who have previously failed other direct-acting antiviral therapies.